A retrospective evaluation of patient profiles, investigations, and treatment modalities used within a pigmentary disorders clinic in Australia

Abstract

Background: Pigmentary disorders are a common presentation in dermatology practice and can be challenging to manage and require expert intervention. Currently, there are limited data on Australian patients presenting with pigmentary disorders. Aims: The aim of the study was to undertake a review of patients presenting with pigmentary disorders and to compare serology, treatment, and quality of life data to global data. Methods: A retrospective, observational study was undertaken in patients attending the pigmentary disorders clinic at The Skin Hospital, Sydney from June 2012 to March 2020. Data collection included demographics, disease duration, baseline nutritional and autoimmune serology, quality of life scores, and treatments undertaken. Results: 776 patients were identified, with 600 patients (54.3%, female) attending for management of pigmentary disorders. The mean age at time of clinic attendance was 34.5 ± 17.0 years. Vitamin D deficiency, anemia, and abnormal thyroid serology were present in 36.5%, 8.4%, and 6.6% of patients, respectively. Among vitiligo patients, a positive family history of vitiligo and autoimmune disease was present in 17.0% and 20.1% of patients, respectively. Serological testing revealed a 29.5% prevalence of thyroid autoimmunity. A mean treatment time of 1.04 ± 0.62 years was required to decrease dermatology life quality index (DLQI) scores from severe to mild (P < 0.001). Based on DLQI scores, 59% of severe and 18% of patients with moderate scores reduced their baseline scores to mild at follow-up (mean follow-up time of 1.21 ± 1.01 years). Conclusion: This study is the first to investigate the profile and management of patients with pigmentary disorders and highlights the need for such a clinic in an increasingly multiracial Australia.