Abstract

BackgroundMany previous studies have reported factors that contribute to health-related quality of life (HRQoL) for a single skin disease. However, little is known about generalized factors associated with HRQoL across skin diseases. The objective of this study was to investigate overall HRQoL, and to identify factors related to severely impaired HRQoL among patients with 16 different skin diseases.MethodsA cross-sectional study of 9845 patients with skin disease was conducted in 9 hospitals in China. HRQoL was assessed with the Chinese version of the Skindex-29 which measures dermatology-specific health along three domains (symptoms, emotions and functioning). With the published Skindex-29 cut-off scores for severely impaired HRQoL, logistic regression models assessed the relationship between severely impaired HRQoL and demographic/clinical characteristics, with adjustments for different skin diseases. To guarantee the models’ convergence, 16 skin diseases with frequencies of at least 100 were included, and the sample size was 8789.ResultsEmotions was the most impaired aspect of HRQoL. Co-existing chronic diseases, 3 years or longer duration, and more severity were identified as associated factors for severely impaired HRQoL for each Skindex-29 domain, and for the aggregate. Being female, under 45 years old, and consuming alcohol were associated with a severely impaired emotion domain; Lack of exercise and smoking were associated with severely impaired symptoms and function domains, respectively.ConclusionsSkin diseases can affect many facets of HRQoL, but the emotional impairment deserves more attention. In addition to skin disease severity, this study shows that other chronic diseases and long duration are correlated with severely impaired HRQoL for patients with 16 clinical common skin diseases. This suggests the need for increased awareness in treating skin disease as a chronic disease. It also suggests that disease management decisions should consider HRQoL improvement, especially emotional conditions, when making management decisions.

Highlights

  • Skin diseases are an enormous global public health burden, with 3 of them among the 10 most prevalent diseases globally [1, 2]

  • 43.4% suffered from other chronic diseases, including respiratory, digestive, and endocrine diseases

  • Employment, nor body mass index (BMI) were found to be associated with severely impaired health-related quality of life (HRQoL). To our knowledge, this is the most extensive crosssectional study to investigate factors on a standardized measure of HRQoL among patients with skin disease, with the ability to simultaneously adjust for multiple skin conditions

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Summary

Introduction

Skin diseases are an enormous global public health burden, with 3 of them among the 10 most prevalent diseases globally [1, 2]. The effect of skin disease on health-related quality of life (HRQoL) has been recognized and documented. Many previous studies on psoriasis, acne vulgaris, cutaneous lupus erythematosus, alopecia areata, urticaria, and vitiligo have demonstrated how these skin diseases impair HRQoL [5,6,7,8,9,10,11]. Age, generalized disease, distribution of lesions, and severity have been determined to be related to the HRQoL of patients with cutaneous lupus erythematosus [7]. Many previous studies have reported factors that contribute to health-related quality of life (HRQoL) for a single skin disease. The objective of this study was to investigate overall HRQoL, and to identify factors related to severely impaired HRQoL among patients with 16 different skin diseases

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