Understanding vitiligo-related concerns through online discourse: an AI-assisted cross-platform study of Chinese and global communities

Objective: To examine major vitiligo-related concerns expressed in Chinese and international social media discourse, and to compare differences in high-frequency questions across two online platforms. Methods: = 891). An AI-assisted workflow was used for translation, keyword extraction, and standardization of user-expressed questions, followed by researcher-led validation and thematic categorization. Extracted content was grouped into nine thematic categories. Cross-platform differences in high-frequency standardized questions were assessed using two-proportion z-tests with Benjamini-Hochberg correction for multiple comparisons. Results: A total of 6,375 keywords were extracted and normalized into 2,419 unique terms. Intervention and treatment were the most frequent thematic category (36.3%), followed by diagnosis and detection (20.9%), psychological impact and progression (10.0%), and hereditary and pediatric factors (7.7%). Across platforms, treatment-related concerns were the dominant shared topic. Compared with Reddit, Baidu showed higher proportions of posts related to healthcare provider or hospital selection, treatment prognosis and recurrence, psychological stress, treatment considerations for special populations, vaccination or preventive measures, and disease transmissibility. In contrast, Reddit showed higher proportions of posts related to medication side effects, treatment accessibility, dosage and treatment duration, and interpretation of diagnostic tests. In addition to treatment and diagnosis, online discussions also highlighted psychosocial distress, stigma, family-related concerns, and relationship anxiety. Conclusion: Vitiligo-related social media discussions on Baidu and Reddit were dominated by treatment-related concerns but differed substantially in the distribution of high-frequency questions across platforms. These findings suggest that social media may provide a useful supplementary window into unmet informational, emotional, and practical needs related to vitiligo, and may help inform more responsive patient education, digital health communication, and patient-centered care strategies.