Skin diseases have always caused an adverse effect on the life of patients. However, only in the last 20 years has this effect begun to be measured consistently through QoL studies [4]. There is a great interest in the evaluation of QoL in dermatological afflictions, given that these diseases usually have a significant impact in social relations, in the psychological state of mind, and in daily activities [2]. Since expectations regarding health and the ability to cope with limitations and incapacities can affect an individual’s perception and satisfaction, two individuals with the same clinical health state may have different impacts regarding their QoL [5].

Since vitiligo does not cause physical deficiency, it is often considered only a cosmetic problem. However, alterations caused by this disease can affect the emotional and psychological well-being of the patient and entail important repercussions in his life. Additionally, vitiligo is a chronic disease with unpredictable natural course turning it into a burden on the QoL of the patients. The disease, which usually has its onset at a time in life where people begin to consolidate their individuality and sexual identity, can have a great impact on the self-image, self-esteem, and interpersonal relations. Actually, it has been reported that people with vitiligo have a negative self-image of their body with low corporal self-esteem. Furthermore, they may suffer stigmatization making them ashamed of their body and damaging their social life [6]. It seems inadequate therefore that to describe the severity of the disease, merely physical indicators are used (i.e., affected body surface area (BSA) or the number of body locations affected). Only 9 % of the studies that evaluate the efficacy of the treatment apply QoL as one of their references [7]. The evaluation of QoL requires specific instruments for its assessment in order to provide a detailed image of the individual impact caused by the disease.

DLQI was developed by Finlay and Kahn in 1994. It was the first questionnaire specifically destined for QoL in dermatology. Of simple construction and with easy routine application, it has already been used in over 272 studies in 32 countries, being available in 55 languages. The questionnaire assesses the events that occurred in the foregoing week, allowing an easy recollection by the patients and can thus be used in comparative studies. The DLQI comprises ten questions addressing six different domains (symptoms, daily activities, leisure, work or school, personal relations, and treatment), and its score varies from zero (least impact in the QoL) to 30 (highest impact in QoL) [9].

CDLQI was developed in 1995 based on the impact of dermatoses on children’s QoL. It presents a similar score structure as DLQI and is recommended to be used for children over 7 years of age [10]. Subsequently, in 2003, an illustrated version of the CDLQI was created, faster and easier to fill out, being preferred by parents and children [11].

Skindex is a useful instrument to measure QoL in patients with different cutaneous diseases. In its initial structure, it comprised 61 items divided in eight dimensions (cognitive effects, social effects, depression, fear, embarrassment, irritation, physical discomfort, and physical limitations) [12]. This is an extensive questionnaire with questions addressing the past 4 weeks, with excellent validity and reliability. Afterward, it was reduced to 29 items, originating the Skindex-29 [13], and later shortened again to 16 items, becoming Skindex-16 [14].

VitiQoL is a scale with 15 items that incorporates the majority of information from preexistent questionnaires specifically aimed at vitiligo and its impact in the foregoing week, with good reliability [15].

VLQI is a form with 25 questions regarding vitiligo, adapted from existent questionnaires and with new additional questions aimed at specific dermatoses such as the Psoriasis Quality of Life Scale (PSORIQoL), Acne Quality of Life Scale (AQOLS), and Atopic Dermatitis Quality of Life Scale (QoLiAD), presenting converging results with DLQI when tested simultaneously [16].

VIS-22 presents with 22 specific questions regarding the disease, adapted from the VIS scale [17], which consisted of 27 questions, but had its number reduced with the purpose to bring greater balance to the evaluation [18].