Improvement in the cutaneous disease activity of patients with dermatomyositis is associated with a better quality of life.

Abstract

Cutaneous dermatomyositis (DM) disease activity is associated with decreased quality of life. To assess if an improvement in quality of life, as measured by the Skindex-29 and patient-reported itch and pain on a 10-point visual analogue scale (VAS), correlated with an improvement in cutaneous DM disease activity. Patients with a completed cutaneous DM disease area and severity index [Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)] at two visits separated by at least 2months were classified into responder (n=15) and nonresponder (n=30) groups according to the point change in the CDASI activity scores between visits. Responders had at least a four-point improvement in CDASI activity, indicating clinically relevant improvement. The change from baseline to the follow-up visit of the Skindex-29 subscale scores for the responders vs. the nonresponders were significantly different for emotions (P<0·01), functioning (P<0·01) and symptoms (P<0·01). The change in VAS score between responders and nonresponders was also significant for itch (P=0·01) and pain (P=0·04). There was no significant difference between the groups in terms of disease subtype, sex, race, age, treatment for DM, smoking history or a history of malignancy within 5years of a diagnosis of DM. This is the first study to demonstrate that the quality of life of patients with DM improved as their cutaneous disease activity decreased.