Background: Autoimmune bullous diseases (ABDs) are chronic relapsing-remitting dermatologic diseases that exert significant impacts on quality of life (QOL). Using Skindex-16, we evaluated the impact of self-reported ABD flares on patients’ QOL. Methods: Skindex-16 is a dermatology-specific QOL measure that assesses skin disease impact on symptoms, emotions and functioning (range 0-100, higher scores = greater QOL impact). Demographic and clinical data for each visit were linked to PRO scores via manual chart review. Associations between PRO score and self-reported flare (“Are you flaring today? Yes/No”) were performed for each disease category (subepiderma, pemphigus, and dermatitis herpetiformis (DH)). Comparisons of Skindex-16 scores and individual item distributions by flaring status were compared using Somers’ D test. Odds of flare was calculated with univariable and multivariable logistic regression. Discrimination of indirect immunofluorescence lab values versus PRO scores was compared with c-index. Results: Between September 2016 and January 2020, we identified 193 patients with 317 visits. On average, patients took 2.44 minutes to complete the Skindex-16. Patients reported flaring at 29.0% of visits. Overall and individual item Skindex-16 were higher for all disease categories when flaring compared with non-flaring (P = .80 for all). Conclusions: ABDs have high morbidity. Flares are common and negatively impact QoL. These results highlight the clinical potential for serial Skindex-16 monitoring to signal clinical changes in patients with ABD.