⏱️ VIDA Score

Vitiligo Disease Activity score — Njoo et al., 1999

Purpose
Six-point, history-based grading of current vitiligo activity, from +4 (active within the last 6 weeks) to −1 (stable ≥ 1 year with spontaneous repigmentation).
Population
Patients with vitiligo (originally vitiligo vulgaris / non-segmental). Based on the patient's own account of disease activity over time.
Definition of activity
Active disease = expansion of existing lesions and/or appearance of new lesions. The score is the time window of the most recent activity.
Interpretation
+4 to +1 = active (decreasing recency) · 0 = stable ≥ 1 year · −1 = stable ≥ 1 year with spontaneous repigmentation. A lower score means less activity; VIDA ≤ 0 is the usual definition of "stable" for surgical candidacy.
🗓️ When was the disease last active?

Ask the patient when new lesions last appeared or existing lesions last enlarged. Select the single option that best fits.

🔍 Clinical signs of activity — complement to VIDA

VIDA relies on recall. Examine for visible signs that indicate active disease regardless of history:

  • Koebner phenomenon — lesions at sites of trauma or friction (Njoo 1999 linked a positive Koebner to higher VIDA).
  • Confetti-like depigmentation — clustered 1–5 mm macules.
  • Trichrome lesions and ill-defined / hypochromic borders (best seen under Wood's light).
  • Inflammatory vitiligo — erythematous raised borders, pruritus.
📚 References
  1. Njoo MD, Das PK, Bos JD, Westerhof W. Association of the Köbner phenomenon with disease activity and therapeutic responsiveness in vitiligo vulgaris. Arch Dermatol. 1999;135(4):407–13.
  2. van Geel N, Speeckaert R, Taieb A, et al. Koebner's phenomenon in vitiligo: European position paper. Pigment Cell Melanoma Res. 2011;24(3):564–73.
  3. van Geel N, Grine L, De Wispelaere P, Mertens D, Prinsen CAC, Speeckaert R. Clinical visible signs of disease activity in vitiligo: a systematic review and meta-analysis. J Eur Acad Dermatol Venereol. 2019;33(9):1667–75.
  4. Seneschal J, Speeckaert R, Taïeb A, et al. Worldwide expert recommendations for the diagnosis and management of vitiligo: position statement from the International Vitiligo Task Force. J Eur Acad Dermatol Venereol. 2023;37(11):2173–84.
Clinical decision support only. This tool is intended to assist clinical assessment and does not replace professional judgment. Always interpret results in the context of the individual patient.