Systematic Review of Clinimetric Instruments to determine the severity of Non-segmental Vitiligo

This systematic review of measurement instruments for vitiligo outcomes included validation articles published from 2011 to May 2018. According to the PRISMA statement, the search was carried out in EMBASE (via OvidSP); MEDLINE (via OvidSP and PubMed). The COSMIN taxonomy will be used to define the measurement properties. Inclusion criteria were original studies reporting measuring properties. Exclusion criteria were clinical trials using scales whose measurement properties were not assessed, studies of cross-cultural adaptation, scales focused on other aspects of the disease such as quality of life, satisfaction, disease's burden. Fourteen studies were identified, which described 15 instruments to measure vitiligo outcomes. Nine of them, measured properties related to the severity of the disease: Vitiligo extent score (VES), Self-Assessment Vitiligo Extent Score (SA-VES), Self-Assessed Vitiligo Area Scoring Index (SAVASI), Vitiligo Area Scoring Index (VASI), Vitiligo European Task Force assessment (VETFa), Vitiligo Noticeability Scale (VNS), Koebner's phenomenon in vitiligo score (K-VSCOR), Vitiligo Extent Tensity Index (VETI), Potential Repigmentation Index (PRI). The most effective tool to asses affected Body Surface Area (BSA) is VES. The VASI is useful to stratify by severity. There is not enough evidence to recommend the use of SAVASI. The VETFa does not offer any difference to calculate the affected BSA compared with the rule of 9's. The VNS and K-VSCOR lack of reliability evidence.