International Consensus Study Defining Vitiligo Severity, Relapse, and Treatment Criteria

This talk presented the INTERCEPT international consensus study, created to address the lack of standardized, patient-inclusive definitions for vitiligo severity and relapse as new treatments emerge. The study used a mixed-method, multi-stage process involving literature and scoping reviews, interviews with 30 diverse patients, and two rounds of eDelphi consensus with 85 participants from 21 countries, including dermatologists, nurses, psychologists, patients, and patient organizations. The group agreed on a two-step severity framework: first, body surface area alone classifies vitiligo as mild if under 3%, moderate from 3% to under 10%, and severe if over 10%; rapidly progressive disease is considered severe regardless of area. Second, moderate cases can be upgraded to severe if they meet one major criterion or two minor criteria. Major criteria include spreading/active disease, involvement of high-impact visible areas, psychosocial distress, stigmatization, lack of self-acceptance, and overall burden; minor criteria include darker skin tone, young age, scalp or facial hair involvement, sunburn risk, career or school impact, and loss of personal or cultural identity. The study emphasized that severity should not rely only on questionnaires or clinician judgment, but also on cultural, social, psychological factors and shared decision-making. Consensus also supported reserving systemic treatment for moderate-to-severe vitiligo, with immediate use in rapidly progressive cases and after at least 12 weeks of failed topical therapy. Relapse was described as loss of repigmentation in previously repigmented lesions, but no agreement was reached on the exact pigment loss threshold, so further work is needed. The presentation also highlighted future research on color match and noted that the study has been published in JAMA Dermatology.