Development and Validation of the Vitiligo Extent Score (VES): an International Collaborative Initiative

J Invest Dermatol. 2016 May;136(5):978-984. doi: 10.1016/j.jid.2015.12.040. Epub 2016 Jan 28.


The clinical assessment of vitiligo involves an estimation of the affected body surface area. The most commonly used method is the "palm of hand 1% rule" as integrated in the Vitiligo Area Scoring Index. However, this method can be challenging and time consuming. In this study, we introduce a global Vitiligo Extent Score (VES). In the first part of the study, this measurement instrument was developed and subsequently optimized during a pilot scoring session. In a subsequent stage, the inter- and intrarater reliability of the instrument were tested. Live scoring showed an excellent interrater reliability for the VES (intraclass correlation VES: 0.924 vs. Vitiligo Area Scoring Index: 0.846). Subsequent scoring on pictures was comparable with the live evaluation and demonstrated an excellent intrarater reliability. A high intraclass correlation for the VES (intraclass correlation VES: 0.923 vs. Vitiligo Area Scoring Index: 0.757) was also found in an additional subgroup of patients with extensive vitiligo. Moreover, user-friendliness and timing were scored very favorably. In conclusion, this measurement instrument allows us to monitor accurately and easily the affected body surface area in a standardized way. Moreover, our results provide evidence that the VES can be proposed as a promising tool to measure the vitiligo extent in clinical trials and in daily practice.

Publication types

  • Validation Study

MeSH terms

  • Adult
  • Cohort Studies
  • Dermatology / methods*
  • Diagnostic Tests, Routine / methods
  • Female
  • Humans
  • Internationality
  • Male
  • Observer Variation
  • Severity of Illness Index*
  • Vitiligo / diagnosis
  • Vitiligo / pathology*
  • Young Adult