Quality of life in patients with allergic and immunologic skin diseases: in the eye of the beholder

Ester Di Agosta,Maddalena Napolitano,Federica Belluzzo,Andrea Paravisi,Rosella Gallo,Paola Lucia Minciullo,Natale Schettini,Laura Bonzano,Maria Passante,Silvia Ferrucci ,Cataldo Patruno,Fabrizio Guarneri,M Fantò ,Ilaria Baiardini,Caterina Foti,Katharina Hansel,Aikaterini Detoraki,Paolo Custurone,Raffaele Brancaccio,Adriana Di Guida,Monica Corazza,Diego Peroni,Domenico Bonamonte,Filippo Fassio,Aurora De Marco,Luca Stingeni,Luisa Angileri,Donatella Lamacchia,Elettra Antonelli,Lucia Guidolin,Cristina Quecchia,Carla Lombardo,Giuseppe Spadaro,Marta Tramontana,Francesca Ambrogio,Roberta Parente,Alessia Gatta,Elisabetta Leo ,Lorenzo Salvati,Daniele Tarrini,Eustachio Nettis,A Pannofino ,Oliviero Riggio

doi:10.1186/s12948-021-00165-6

Abstract

Allergic and immunologic skin diseases negatively impact the quality of life (QoL) of affected patients with detrimental consequences. Nonetheless, in everyday clinical practice the evaluation of QoL is often overlooked. Considering the increasing prevalence of atopic dermatitis, allergic contact dermatitis, hereditary angioedema, cutaneous mastocytosis, and urticaria, it is essential to determine the effects of allergic and immunologic skin diseases on QoL. A joint meeting (GET TOGETHER 2021) of the Italian Society of Allergology, Asthma and Clinical Immunology (SIAAIC) and the Italian Society of Allergological, Occupational and Environmental Dermatology (SIDAPA) aimed to summarize the features of the main QoL tools used in these diseases and to describe the extent of QoL impairment as well as the impact of treatments on QoL, particularly biologic therapies. The assessment of QoL in patients with allergic and immunologic skin diseases relies on generic, organ-specific and disease-specific questionnaires. While generic and organ-specific questionnaires allow comparison between different diseases, disease-specific questionnaires are designed and validated for specific cohorts: the QoL Index for Atopic Dermatitis (QoLIAD) and the Childhood Atopic Dermatitis Impact Scale (CADIS) in atopic dermatitis, the ACD-11 in allergic contact dermatitis, the Angioedema QoL Questionnaire (AE-QoL) and the Hereditary Angioedema QoL questionnaire (HAE-QoL) in hereditary angioedema, the Mastocytosis QoL Questionnaires (MCQoL e MQLQ) in cutaneous mastocytosis, and the Chronic Urticaria QoL questionnaire (CU-Q2oL) in urticaria. Among the many factors that variably contribute to QoL impairment, pruritus can represent the leading cause of patient discomfort. Biologic therapies significantly ameliorate QoL in atopic dermatitis, hereditary angioedema, mastocytosis and chronic urticaria. In general, adequate management strategies are essential for improving QoL in patients with allergic and immunologic skin diseases.

Highlights

Generic Questionnaires: assessing QoL in patients with allergic and immunologic skin diseases Generic questionnaires are designed to assess health related quality of life (HRQoL) in wide populations with or without chronic conditions and they allow comparing different diseases [2, 3]
The GET TOGETHER 2021 meeting, organized by SIAAIC (Società Italiana di Allergologia, Asma ed Immunologia Clinica) and Italian Society of Allergological (SIDAPA) (Società Italiana di Dermatologia Allergologica, Professionale e Ambientale) was a virtual meeting held by specialists in allergic and immunologic skin diseases in Italy between May and June 2021 with the primary aim to discuss and review the current knowledge on the QoL of patients with atopic dermatitis, allergic contact dermatitis, hereditary angioedema, cutaneous mastocytosis, and urticaria
The Dermatology-Specific Quality of Life (DSQL) provides valid and reliable assessments of QoL impairment associated with acne and contact dermatitis; it is used to quantify the effects of skin disease on physical discomfort and symptoms, psychological wellbeing, social functioning, self-care activities, performance at work or school, and self-perceptions [8, 9]

Summary

Background

“The value of experience is not in seeing much, but in seeing wisely” Sir William Osler [1849–1919]. Quality of life (QoL) of patients with allergic and immunologic skin diseases is often a neglected issue in clinical practice [1]. The GET TOGETHER 2021 meeting, organized by SIAAIC (Società Italiana di Allergologia, Asma ed Immunologia Clinica) and SIDAPA (Società Italiana di Dermatologia Allergologica, Professionale e Ambientale) was a virtual meeting held by specialists in allergic and immunologic skin diseases in Italy between May and June 2021 with the primary aim to discuss and review the current knowledge on the QoL of patients with atopic dermatitis, allergic contact dermatitis, hereditary angioedema, cutaneous mastocytosis, and urticaria. Considering the increasing prevalence of allergic and immunologic skin disorders, it becomes fundamental to evaluate their impact on the QoL of affected patients, as well as the effect of current therapies on QoL

Main text

Limitations in patients with ACD

Findings

Conclusions