High Segmental Fraction and Intensive Phototherapy Utilisation in Indonesian Vitiligo: A Five-Year Retrospective Tertiary-Centre Study in Surakarta, Indonesia

Abstract

Background: Vitiligo is the most common acquired depigmenting disorder, yet Indonesian epidemiological and treatment-pattern data remain scarce.

Objective: To characterise the clinical phenotype, anatomical distribution and treatment utilisation of vitiligo at an Indonesian tertiary centre and to test them against published reference proportions.

Methods: This STROBE-compliant retrospective study included all 175 patients coded ICD-10-CM L80 at the Dermatology and Venereology Outpatient Clinic of Dr. Moewardi Regional General Hospital, Surakarta, between January 2020 and December 2024, identified by consecutive total sampling. Proportions were estimated with Wilson 95% confidence intervals, compared with published international and Indonesian reference proportions using two-proportion tests with Cohen's h, and analysed by multivariable logistic regression, receiver-operating-characteristic and Poisson models.

Results: Patients were predominantly female (57.71%) and young (70.86% aged under 40 years). Nonsegmental disease predominated (62.29%), but the segmental fraction (37.71%; 95% CI 30.87–45.09) exceeded an international tertiary-cohort reference of 5.93% by 31.78 percentage points (h = 0.831; p < 0.001). Phototherapy reached 74.86%, exceeding United States real-world utilisation of 3.9% by 70.96 points (h = 1.694), and only 0.57% remained untreated against 27% internationally. Multiple lesions (adjusted odds ratio 8.39; 95% CI 3.41–20.64) and nonsegmental disease (3.59; 1.46–8.79) independently predicted phototherapy (area under the curve 0.859).

Conclusion: Indonesian tertiary vitiligo care is phototherapy-intensive and markedly enriched for segmental disease, warranting consensus-based classification and phototherapy dosimetry documentation.