Children's Dermatology Life Quality Index Research Articles

Evaluation of quality of life scores and family impact scales in pediatric patients with alopecia areata: a cross-sectional cohort study.

There are a limited number of studies evaluating the effects of alopecia areata (AA) on the health-related quality of life (HRQoL) of pediatric patients and their families. This study aimed to assess the HRQoL of pediatric patients with AA and their parents. This single-center cross-sectional cohort study included 72 pediatric patients diagnosed with AA. The study was conducted between December 2020 and December 2021 in the dermatology department of a single tertiary center in Turkey. The HRQoL index of the pediatric patients was assessed with the Children's Dermatology Life Quality Index (CDLQI). At the same time, their parents, who were primarily involved in the disease process, were evaluated using the Dermatological Family Impact Scale (DeFIS). An ordinal logistic regression model was used to detect predictors for CDLQI severity. The mean ± SD CDLQI of the pediatric patients who participated in our study was 8.4 ± 5.3, corresponding to moderate impairment. The highest impairment in CDLQI was observed in the symptoms and feelings domain, while the slightest impairment was observed in the domain of personal relationships (P < 0.001). There was a statistically significant positive correlation between the Severity of Alopecia Tool (SALT) score and all CDLQI domains, and the most substantial relationship was with the leisure domain (r = 0.78, P < 0.001). DeFIS scores of female patients were substantially higher than males (25.3 ± 8.6 vs. 17.6 ± 9, P = 0.001). Our study supports that AA is a disease that significantly impacts the HRQoL of affected children and their families.

Impact of atopic dermatitis on quality of life in children and their families: A tertiary care hospital-based study from Northern India

Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease that is more frequent among children. Childhood is a critical time for physical and psychosocial development and AD develops more commonly in children in the first five years of life. The objective of the study was to determine the impact of AD on the quality of life (QoL) of Indian children and their families and correlate it with AD severity and the perception of severity as estimated by the family. Material and Methods: In the present study, 30 children clinically diagnosed with AD and 30 age- and sex-matched healthy controls presenting to our hospital were evaluated. Data on QOL were obtained through a questionnaire; Infants Dermatitis Quality of Life Index (IDQOL), Children’s Dermatology Life Quality Index (CDLQI), and Dermatology Life Quality Index (DQLI) were used for patients,and the Dermatitis Family Impact (DFI) questionnaire for the family of the patients. The severity of the disease was determined using the Scoring for AD (SCORAD) index. Results: In our study, there were 16 male patients and 14 female patients. History of atopy was significantly higher in children with AD (p &lt;0.001); 13 patients had mild, 17 had moderate, and none of the patients had severe disease. The severity of the disease was found to correlate negatively with the age of the child. IDQOL positively correlated with the age of children with AD (r = 0.865, P &lt; 0.001). CDLQI negatively correlated with the age of children with AD (r = −0.616, P = 0.033). Impairment in IDQOL and CDLQI showed a significant positive correlation with DFI (r = 0.846, P &lt; 0.001; r = 0.910, P &lt; 0.001). Conclusion: AD is associated with lowered QOL of the patient,which increases with the severity of the disease. Itch and sleep disturbance were the most severely affected symptoms of AD. The disease significantly impacted the QOL of the family. The main issue with parents caring for AD children is continuous expenditure on treatment, emotional distress, and physical exhaustion. Therefore, efforts are needed to help parents by medical care personnel so that the outcomes in both the child and the significantly burdened parent caregiver can be improved.

Assessing the impact of childhood and adolescent chronic plaque psoriasis on parents/caregivers using the Family Dermatology Life Quality Index (FDLQI): A cross-sectional study.

Background Chronic childhood diseases are a burden for paediatric patients and their caregivers. Limited data are available on the effect of paediatric psoriasis on the caregiver's well-being and quality of life. Objective To assess the impact of childhood and adolescent chronic plaque psoriasis on parents/caregivers quality of life. Methods A single-centre cross-sectional study was performed which included 102 children with psoriasis and their caregivers. Clinico-demographic data of children and socio-demographic details of primary caregivers were collected. Out of pocket expenditure for treatment was calculated for all the patients. The quality of life of children was assessed using the Children's Dermatology Life Quality Index (CDLQI) and the caregiver's quality of life was assessed using the Family Dermatology Life Quality Index (FDLQI). Results CDLQI was impaired in 85.29 % of children with a median score of 7. The item 'symptoms' was most commonly affected (87.2%), followed by 'self-conscious' (70.5%) and 'treatment' (65.6%). FDLQI was impaired in 96.1% of caregivers with a median value of 11. The most affected FDLQI items were 'emotional' in 95%, followed by 'time-spent' in 78.4%. Almost 40% of patients had catastrophic health expenditure (CHE) and their FDLQI was significantly higher (p-0.014) compared to caregivers who did not experience catastrophic health expenditure. FDLQI had a positive relationship with the involvement of exposed body sites (p-0.003), CDLQI (p-0.000), treatment expense (p-0.031) and a negative correlation with duration of illness (p-0.04). Conclusion Childhood psoriasis has a negative impact on the quality of life of the children and caregivers highlighting the need for intervention strategies for both.

Impact of Atopic Dermatitis on Quality of Life of Caregivers: A Systematic Review and Meta-Analysis.

Abstracts: Background: Atopic dermatitis (AD) is a chronic dermatological condition that affects both patients and their caregivers. Aims: To summarize evidence on the impact of AD on the quality of life (QoL) of caregiver. Methods: Observational studies were searched for in Medline, Embase, Cochrane Library, SCOPUS, and CINAHL databases up till March 1, 2023. Results: Seventy studies with a total of 33,291 study participants were identified. The Dermatitis Family Index (DFI) questionnaire featured in 29 studies and was chosen for further meta-analysis. The pooled DFI for all studies was 9.35 (95% confidence interval [CI] 6.94-11.76). For individual components, the highest component scores were for 1.24 for expenditure (95% CI 0.80-1.69), followed by 1.14 for emotions (95% CI 0.77-1.50), as well as sleep 1.12 (95% CI 0.71-1.54) and exhaustion 1.12 (95% CI 0.76-1.48). Meta-analysis on the effect of patient QoL on family QoL was conducted on 15 studies, with a pooled Spearman's rank coefficient using Infants' Dermatitis Quality of Life Index (IDQoL) was 0.632 (95% CI 0.558-0.707), whereas that using Children's Dermatology Life Quality Index (CDLQI) was 0.624 (95% CI 0.507-0.741). For the 17 studies correlating AD severity with family QoL, a pooled Spearman's rank coefficient of 0.425 (95% CI 0.330-0.521) was obtained. Conclusions: AD is associated with significant negative impacts on caregiver QoL, particularly in family finance, caregiver burnout, and sleep impairment. This was consistently affected by AD severity and patient QoL in all studies examining this association.

Comparing the Quality of Life of Patients and their Family Members with Dermatological and other Chronic Conditions, in The Bahamas

Background &amp; Objectives: Impact of dermatological and other chronic conditions not only affects the quality of life (QoL) of patients but also that of their family members. This pilot study aimed to compare the QoL impact of dermatological and other chronic conditions on patients with the QoL impact on their family members. Methods: A cross-sectional study using validated QoL questionnaires was conducted. In the dermatological group, patients (&gt;17 years) completed the Dermatology Life Quality Index (DLQI) questionnaire, while children (4-16 years) completed the Children’s Dermatology Life Quality Index (CDLQI) questionnaire. Family members (&gt;18 years) completed both Family Reported Outcome Measure (FROM-16) and Family Dermatology Life Quality Index (FDLQI) questionnaires. In the other chronic conditions group, patients (&gt;17 years) completed the World Health Organization Quality of Life -BREF (WHOQoL-BREF) questionnaire and children (4-17 years) completed The Revised Children’s Quality of Life Questionnaire (KINDL-r: Kiddy KINDL, Kid KINDL and Kiddo KINDL). Family members completed the FROM-16 questionnaire. Data were analysed using IBM SPSS™ statistical software. Results: Forty-four participants completed the study. In the dermatological group (n=26), there was a weak negative correlation between DLQI and FDLQI scores (r= –0.23, p=0.55) not between DLQI and FROM-16 (r = –0.04, p=0.92). There was a very strong positive relationship between both CDLQI and FDLQI (r=0.83, p=0.17) and CDLQI and FROM-16 (r=0.82, p=0.18). Although not statistically significant, there may be a correlation between the FROM-16 and FDLQI scores for family members of dermatology patients. In the chronic conditions group (n=18) the mean score of WHOQoL-BREF was 90.5 (SD=13) with a significant negative inverse relationship to FROM-16 (r= –1.000, p=&lt;0.001). The KINDL-r scores (mean=66, SD =11) showed no significant correlation (r= –0.24, p=0.61) with FROM-16 scores (mean=9.6, SD=3.7). Conclusion: The impact of a patient’s dermatological or other chronic condition can not only negatively affect the patient’s QoL but also the QoL of their family members.

Impact of Crisaborole in Treatment-Experienced Patients With Mild-to-Moderate Atopic Dermatitis.

Background: Crisaborole ointment, 2%, is a nonsteroidal phosphodiesterase 4 inhibitor for the treatment of patients with mild-to-moderate atopic dermatitis (AD). Objective: To assess the efficacy and safety of crisaborole in patients with AD who had received prior treatment with (a) corticosteroids (systemic or topical) or topical calcineurin inhibitors (TCIs) or (b) topical corticosteroids (TCSs) or TCIs or (c) who were treatment-naive (TN). Methods: This post hoc analysis comprised patients aged ≥2 years with mild-to-moderate AD. Patients were assigned (2:1) to receive crisaborole or vehicle twice daily for 28 days. Patient response was assessed with the Investigator's Static Global Assessment (ISGA), Dermatology Life Quality Index (DLQI), Children's Dermatology Life Quality Index (CDLQI), and Dermatitis Family Impact (DFI) tools. Safety was also assessed. Results: A significantly higher percentage of patients treated with crisaborole versus vehicle achieved ISGA success regardless of treatment history. Patients treated with crisaborole had significant reductions in DLQI, CDLQI, and DFI scores versus those who received vehicle regardless of treatment history, with the exception of DLQI and DFI scores in the TN group. Crisaborole was well tolerated in all subgroups. Conclusion: Crisaborole demonstrated a favorable efficacy and safety profile in both treatment-experienced and TN patients. ClinicalTrials.gov, NCT02118766 and NCT02118792.

Cross-sectional nationwide epidemiologic survey on quality of life and treatment efficacy in Japanese patients with congenital ichthyoses

BackgroundCongenital ichthyoses sometimes present with severe skin symptoms that significantly affect the patient’s quality of life (QOL). Symptomatic treatments are the mainstay therapies, and their efficacy is limited and inadequate. ObjectiveTo assess the disease severity and QOL in patients with congenital ichthyoses, and to investigate the effectiveness of current treatments. MethodsWe conducted a questionnaire-based Japan-wide epidemiological survey of patients with congenital ichthyosis who received medical care from 1 January 2016–31 December 2020. Effectiveness of past and current treatments was assessed. The outcomes were the physician’s assessment, disease severity assessed using the clinical ichthyosis score (CIS), and the disease burden estimated using the Dermatology Life Quality Index (DLQI), the Children’s Dermatology Life Quality Index (CDLQI), and the Infants’ Dermatitis Quality of Life Index. ResultsOne hundred patients with 14 ichthyosis subtypes from 47 institutes were included in the final analysis. The CDLQI score showed a positive correlation with CIS (rs = 0.59, p = 0.004), while the DLQI score showed no significant correlation (rs = 0.13, p = 0.33). All existing medications were effective for many patients. Etretinate improved QOL and reduced CIS, but side effects including bone growth retardation were reported. Decreased treatment willingness was observed in patients with very low and very high CIS. ConclusionQOL scores were found to correlate with CIS in children, but not in adults. Considering the adverse events, it is speculated that etretinate is not indicated for children with mild cases. Petrolatum was the most commonly used medication, even in patients who were reluctant to receive treatment.

Clinically meaningful change threshold in health‐related quality of life among patients aged 6 months to 5 years with atopic dermatitis and their caregiver(s)/family

AbstractBackgroundAtopic dermatitis (AD) significantly impacts health‐related quality of life (HRQoL) in children and their caregiver(s)/family. Measures to assess HRQoL include the Children's Dermatology Life Quality Index (CDLQI), Infants' Dermatitis Quality of Life Index (IDQoL) and Dermatitis Family Impact (DFI) questionnaire. Currently, there are no established clinically meaningful within‐person change thresholds for these measures in young children (6 months to 5 years) and their caregiver(s)/family.ObjectivesTo determine the clinically meaningful within‐person change thresholds for CDLQI (4–5 years), IDQoL (&lt;4 years) and DFI scores in children aged 6 months to 5 years with moderate‐to‐severe AD and their caregiver(s)/family.MethodsData from the 16‐week, randomised, double‐blind, placebo‐controlled, phase 3 LIBERTY AD PRESCHOOL part B study in children aged 6 months to 5 years were used. The anchor‐based method was used to assess meaningful change thresholds for the three instruments, using the Caregiver Global Impression of Disease (CGID; range: ‘no symptoms’ to ‘very severe’) as the primary anchor, and Caregiver Global Impression of Change (CGIC; range: ‘much better’ to ‘much worse’) as a supportive anchor.ResultsThe mean CDLQI change scores were −6.3 and −9.5 based on CGID 1‐point improvement and CGIC improvement of ‘a little better’, respectively. The mean IDQoL change scores were −5.6 and −3.4 based on the CGID and CGIC anchors. The mean DFI change scores were −7.0 and −6.7 based on the CGID and CGIC anchors.ConclusionsBased on primary anchor findings, improvements of ≥6 points on the CDLQI total score for children aged 4–5 years and on the IDQoL total score for children aged &lt;4 years were recommended as the clinically meaningful within‐person change thresholds in children with moderate‐to‐severe AD. A 7‐point improvement on the DFI total score may be considered as the meaningful threshold for the caregiver(s)/family of children aged 6 months to 5 years with moderate‐to‐severe AD.

Clinically relevant improvements in adults and adolescents with atopic dermatitis who did not achieve Investigator's Global Assessment treatment success following 8 weeks of ruxolitinib cream monotherapy.

Ruxolitinib cream is a topical formulation of ruxolitinib, a selective inhibitor of Janus kinase (JAK) 1 and JAK2. In two phase 3 studies in adults and adolescents (aged ≥12 years) with atopic dermatitis (AD; TRuE-AD1/TRuE-AD2), significantly more patients who applied ruxolitinib cream versus vehicle cream achieved Investigator's Global Assessment treatment success (IGA-TS; IGA score of 0/1 with ≥2-point improvement from baseline) at week 8 (primary endpoint). This post hoc analysis evaluated the efficacy, safety, and disease control of ruxolitinib cream in patients with AD who did not achieve IGA-TS at week 8. Patients in TRuE-AD1/TRuE-AD2 (N = 1249) were randomized 2:2:1 to apply twice-daily 0.75% ruxolitinib cream, 1.5% ruxolitinib cream, or vehicle cream for 8 weeks followed by a long-term safety period in which patients applied ruxolitinib cream as needed. In this pooled analysis, clinically meaningful response thresholds included ≥50% improvement in the Eczema Area and Severity Index, ≥2-point reduction in the Itch Numerical Rating Scale, ≥4-point improvement in the Dermatology Life Quality Index (DLQI) or ≥6-point improvement in Children's DLQI, and ≥1-point reduction in IGA from baseline. Among patients who did not achieve IGA-TS at week 8 (n = 584), significantly more patients who applied either strength ruxolitinib cream versus vehicle achieved each response threshold at week 8. A response in ≥1 clinically meaningful endpoint was achieved in significantly more patients who applied ruxolitinib cream (93.4%/90.9% for 0.75%/1.5% ruxolitinib cream, respectively) versus vehicle (69.0%, both P < 0.0001). Progressive improvements in disease control were observed, with many patients achieving IGA-TS by week 52 (55.2%/56.3% for 0.75%/1.5% ruxolitinib cream, respectively). Ruxolitinib cream was well tolerated during the 52-week study in this patient population. Taken together, these results demonstrate that most patients with AD who did not achieve IGA-TS at week 8 have clinically meaningful responses to ruxolitinib cream, and continued therapy beyond 8 weeks could result in additional benefit.

Investigation of Quality of Life of Patients with Atopic Dermatitis and Quality of Life, Psychiatric Symptomatology, and Caregiver Burden of Their Mothers.

The purpose of the present research was to evaluate the quality of life of patients with atopic dermatitis (AD), and that of their mothers. We compared the anxiety and depression scores and caregiving burden of mothers of patients with AD with the same scores of mothers of healthy children. A total of 153 patients between the ages of 2 months and 16 years with AD in our clinic, and their mothers, were contained in the patient group. An additional 141 healthy cases between the ages of 2 months and 16 years, and their mothers, were included as the control group. The Children's Dermatology Life Quality Index (CDLQI) was completed according to the children's opinions, and the Infant's Dermatitis Quality of Life Index (IDLQI), Family Dermatology Life Quality Index (FDLQI), Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Temperament Evaluation of Memphis, Pisa, Paris and San Diego Autoquestionnaire, and Zarit Caregiver Burden (ZCB) scale were completed based on the mothers' opinions. We detected a positive relationship between the SCORAD index and the IDLQI, CDLQI, and FDLQI scores of children with AD. We found that anxiety, depression, and caregiving burden in mothers of AD cases increased when mothers of AD cases were compared with mothers of healthy children (p < 0.0001, p < 0.0001, and p < 0.002, respectively). Also, based on the mothers' responses, we noted a positive correlation among the BDI, BAI, ZCB, and SCORAD index scores. Our study found that the quality of life of patients with AD, and that of their mothers, was negatively affected by the disease. We also found that anxiety, depression levels (not at the clinical diagnosis level, and the caregiving burden in mothers of AD cases increased when mothers of AD cases were compared with mothers of healthy children.

Quality of life in children with skin disease: A Spanish sample

IntroductionThe impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. Material and methodsWe conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children’s Dermatology Life Quality Index (CDLQI). ResultsIn our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DiscussionAtopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.

O06 Novel multispectral imaging vs. clinical assessment to assess disease activity in paediatric morphoea

Abstract The assessment of disease activity in paediatric morphoea is challenging. Clinical examination and the Localized Scleroderma Cutaneous Assessment Tool (LoSCAT) are subjective. Thermography is the monitoring tool of choice but has a high rate of false-positive results, with low specificity. Multispectral imaging (measuring depth, volume, haemoglobin and melanin) may provide a noninvasive objective assessment of disease activity. The aim of this study was to compare activity assessment with multispectral imaging vs. clinical assessment in children with morphoea. 3D images of site-matched affected and unaffected skin were obtained using a handheld portable Antera 3D camera (Miravex Ltd). Analysis of depth, volume, haemoglobin and melanin was performed using the Antera Clinical Studies software. Objective and subjective clinical assessment was performed using LoSCAT and Children's Dermatology Life Quality Index (CDLQI). To date, 17 children (age range 7–18 years) have been recruited. Two-thirds (65%) had linear morphoea and 58% were treated with systemic agents (pulsed methylprednisolone, methotrexate, mycophenolate mofetil, abatacept). Average LoSCAT scores were 20.6 (range 5–73), and average CDLQI scores were 3.7 (range 0–14). The average haemoglobin gradient between affected and unaffected skin was 0.3 in children with active disease and 0.08 in those who had persistent disease remission (P &amp;lt; 0.0001). The sensitivity of multispectral imaging in paediatric morphoea is 90% with specificity of 100%, giving a positive predictive value of 100%, and a negative predictive value of 95%. Multispectral imaging of affected skin may aid activity detection in paediatric morphoea and is particularly useful in darkly pigmented skin.

Estudio de la calidad de vida en Dermatología Pediátrica: un ejemplo de la población española

IntroductionThe impact of skin diseases on quality of life varies widely, and some can have an impact similar to that of asthma or cystic fibrosis. Material and methodsWe conducted a cross-sectional, observational and descriptive study with the aim of describing the degree to which quality of life was affected in paediatric patients managed in a dermatology clinic by means of the Children's Dermatology Life Quality Index (CDLQI). ResultsIn our study, the skin disease with the greatest impact on quality of life was atopic dermatitis, chiefly on account of symptoms like pruritus and insomnia. It was followed by acne, mainly due to the associated negative feelings (shame, sadness, etc.). Quality of life in patients with viral warts and molluscum contagiosum was mostly affected by the treatment, chiefly based on cryotherapy. Most patients with nevi or café-au-lait spots did not have a decreased quality of life, although up to one third of them had negative feelings in relation to their skin disease. DiscussionAtopic dermatitis was the common skin disease that caused the greatest impairment in quality of life in our sample, although other diseases also had an impact on different dimensions of quality of life. We ought to underscore the recommendation to use less painful treatments than cryotherapy for viral warts and molluscum contagiosum, as the impairment in quality of life in paediatric patients with these conditions was mainly due to the treatment.

A Comprehensive Assessment of Long-Term Complications in Patients with Stevens-Johnson Syndrome and Toxic Epidermal Necrolysis

Introduction: Stevens-Johnson syndrome (SJS), toxic epidermal necrolysis (TEN), and SJS/TEN overlap syndrome are rare severe hypersensitivity reactions that lead to epithelial sloughing. Studies investigating the chronic multisystem effects of these syndromes and assessing patients in terms of quality of life (QOL), depression, and anxiety in the pediatric population are limited. In this study, we aimed to investigate the long-term effects of these diseases from a multisystem perspective. Method: Sixteen pediatric patients diagnosed with SJS, TEN, and SJS/TEN overlap syndrome were evaluated between September 2020 and March 2021. Physical and eye examinations were performed. To evaluate QOL and psychological status, Children’s Dermatology Life Quality Index (CDLQI), Screen for Child Anxiety-Related Emotional Disorders (SCARED), and Children’s Depression Inventory (CDI) were conducted. The patients’ general characteristics, symptoms, and examination findings at their first admission were retrospectively obtained from the hospital’s electronic records. Results: Nineteen percent of the patients were female (n = 3). There were 7 patients (44%) with the diagnosis of SJS, 5 patients (31%) with TEN, and 4 patients (25%) with SJS/TEN overlap. The median follow-up time of the subjects was 6.5 years. The most common sequelae in the chronic period were skin changes (n = 13, 81%). Hyperpigmentation was the most common skin change (n = 9, 56%). In the last evaluation, 9 cases had eye involvement. In two cases, eye examination was normal in the acute phase, while ocular involvement was present in the chronic period. In 4 (50%) patients, there was height and/or weight percentile loss. Three patients’ SCARED scores and 2 patients’ CDI scores were high. According to the CDLQI survey, SJS, TEN, or SJS/TEN overlap syndrome had a small to moderate effect on the QOL in the 43% (n = 6) of the patients. The ANA values of 3 patients (60%) were positive at the follow-up and negative at the first admission. Conclusion: SJS, TEN, and SJS/TEN overlap syndrome may cause sequelae even after a long time of the onset of the disease. Patients’ QOL and psychological status can be affected negatively. Ocular symptoms may develop in the follow-up, even without involvement in the acute period. Patients with SJS, TEN, and SJS/TEN overlap syndrome should be followed up in the chronic period and approached multidisciplinary.

Impact of Pediatric Dermatologic Conditions on Child and Parent Quality of Life.

Dermatologic conditions can confer a negative effect on pediatric patients and their caretakers. We aim to study the relationship between child and parent quality of life among various dermatoses to further understand the psychosocial impacts of dermatologic disease.We conducted a cross-sectional study of 100 pediatric patients (aged 7-18) and 98 parents who presented to the Pacific Skin Institute, Sacramento, CA, from November 2020 to January 2022. Patients and their parents were evaluated using the Children's Dermatology Life Quality Index (CDLQI) and Family Dermatology Life Quality Index (FDLQI). The maximum score for both indices was 30, with a higher score indicating greater impairment on quality of life.From all the patients and parents identified for various dermatoses, FDLQI scores (mean, 7.8; n = 98) exceeded CDLQI scores (mean, 5.8; n = 100) in nearly every condition. Acne was the only diagnosis with greater CDLQI scores (mean, 9.2; n = 43) than FDLQI scores (mean, 8.8; n = 42). Psoriasis had the greatest difference between FDLQI scores (mean, 10.4; n = 9) and CDLQI scores (mean, 5.9; n = 9).Our study found that parents of children with dermatologic conditions often experience a greater impairment on quality of life compared to the patient. This is likely because parents are highly involved in the management of their child's condition and are burdened with the costs associated with dermatoses. These findings call for a more holistic evaluation by clinicians and the expansion of resources for patients and their parents.

An overlooked burden of acne in adolescents: the psychosocial well-being of their families

IntroductionAcne vulgaris is significantly associated with an increased burden of care and has an important impact on the quality of life (QoL) and self-esteem of affected individuals. We aimed to assess the QoL of adolescents with acne and their families as well as the association of QoL with acne severity, treatment response, duration of acne and localization of lesions. Material and MethodsThe sample included a total of 100 adolescents with acne vulgaris, 100 healthy controls and their parents. We collected data on sociodemographic characteristics, presentation of acne, duration of acne, treatment history, treatment response, and parental sex. We used the Global Acne Severity scale, Children’s Dermatology Life Quality Index (CDLQI), and the Family Dermatology Life Quality Index (FDLQI). ResultsIn the group of patients with acne, the mean CDLQI score in the patients was 7.89 (SD, 5.43) and the mean FDLQI score in the parents was 6.01 (SD, 6.11). In the control group, the mean CDLQI score in healthy controls was 3.92 (SD, 3.88) and the mean FDLQI score in their family members was 2.12 (SD, 2.91). We found a statistically significant difference between the acne and control groups in CDLQI and FDLQI scores (P < .001). There were also statistically significant differences in the CDLQI score based on the duration of acne and the response to treatment. ConclusionsPatients with acne and their parents had a decreased QoL compared with healthy controls. Acne was associated with impaired QoL in family members. Assessing QoL in the family in addition to that of the patient may allow an improved management of acne vulgaris.

PA26 Paediatric atopic dermatitis: correlation between Eczema Area Severity Index, quality of life and visual analogue scale severity scores reported by children and their parents, and in different age groups

Abstract Atopic dermatitis (AD) often has a significant impact on the quality of life (QoL) of those affected and their families. Validated QoL and visual analogue scales (VAS) are widely used in dermatology to measure the impact of this common disease. As part of a larger prospective study, we subanalysed data to look at the correlation between Eczema Area and Severity Index (EASI) score, three different QoL scores and parental/child VAS scores for overall severity, itch and sleep disturbance. Data were analysed from 68 paediatric patients with AD (42 males, 26 females), aged 4–16 years (mean 10 years, 0 months). Patient age groups were subdivided into 4–8 years (n = 17), 8–12 years (n = 25) and 12–16 years (n = 26). Scores for EASI, Children’s Dermatology Life Quality Index (CDLQI), Patient Oriented Eczema Measure (POEM) and Dermatitis Family Impact questionnaire (DFI) were measured, and VAS scores (0–10) were assessed for overall severity, itch and sleep loss. The mean EASI score for the cohort was 18.3, and comparable for all age groups: 4–8 years (17.6), 8–12 years (18.1) and 12–16 years (19.0). The CDLQI correlated with DFI (r = 0.72), POEM (r = 0.66) and overall VAS severity scores (r = 0.61). Further analysis by age group showed CDLQI correlated with POEM and DFI most strongly in younger age groups (4–8 years: POEM r = 0.86; DFI r = 0.77; 8–12 years: POEM r = 0.72; DFI r = 0.81) compared with older children aged (12–16 years: POEM r = 0.41; DFI r = 0.53). The CDLQI and VAS overall severity scores correlated consistently across age groups (4–8 years, r = 0.59; 8–12 years, r = 0.67; 12–16 years, r = 0.66). By comparing EASI with CDLQI scores, moderate correlation was found between the age groups (4–8 years, r = 0.39; 8–12 years, r = 0.53; 12–16 years, r = 0.46). Comparing EASI with the three VAS severity scores, we found poor correlation between EASI score and overall severity score (r = 0.24). This was most marked in the 4–8 years group (n = 17, r = 0.04) vs. the 8–12 years group (n = 25, r = 0.27) and 12–16 years group (n = 22, r = 0.33). Similarly, there was poor correlation between EASI and sleep loss score (r = 0.21) and itch score (r = 0.35) across all age groups. In our study, all of the existing validated QoL scores above correlated well with each other and across different age groups. The CDLQI and VAS severity scores also correlated consistently at all ages. There was poor correlation between EASI and VAS severity scores. This was more apparent in younger age groups, implying a high degree of caregiver distress due to eczema in younger children. This may indicate that as children mature their own perception of eczema may diverge from the perceived parental disease severity/impact on the family.

Una carga ignorada del acné en adolescentes: el bienestar psicosocial de la familia

IntroductionAcne vulgaris is significantly associated with an increased burden of care and has an important impact on the quality of life (QoL) and self-esteem of affected individuals. We aimed to assess the QoL of adolescents with acne and their families as well as the association of QoL with acne severity, treatment response, duration of acne and localization of lesions. Material and methodsThe sample included a total of 100 adolescents with acne vulgaris, 100 healthy controls and their parents. We collected data on sociodemographic characteristics, presentation of acne, duration of acne, treatment history, treatment response, and parental sex. We used the Global Acne Severity scale, Children's Dermatology Life Quality Index (CDLQI), and the Family Dermatology Life Quality Index (FDLQI). ResultsIn the group of patients with acne, the mean CDLQI score in the patients was 7.89 (SD, 5.43) and the mean FDLQI score in the parents was 6.01 (SD, 6.11). In the control group, the mean CDLQI score in healthy controls was 3.92 (SD, 3.88) and the mean FDLQI score in their family members was 2.12 (SD, 2.91). We found a statistically significant difference between the acne and control groups in CDLQI and FDLQI scores (P<.001). There were also statistically significant differences in the CDLQI score based on the duration of acne and the response to treatment. ConclusionsPatients with acne and their parents had a decreased QoL compared with healthy controls. Acne was associated with impaired QoL in family members. Assessing QoL in the family in addition to that of the patient may allow an improved management of acne vulgaris.

409 Efficacy and safety of upadacitinib in adults and adolescents with moderate-to-severe atopic dermatitis: subgroup analysis of the Measure Up 1, Measure Up 2 and AD Up phase 3 clinical trials at 52 weeks

Abstract Atopic dermatitis (AD) is a chronic inflammatory skin disease characterized by eczematous morphology and intense pruritus. Previous clinical trials have demonstrated that upadacitinib (UPA) was superior to placebo (PBO) in the treatment of moderate-to-severe AD. Here, we analyse the efficacy and safety of UPA across 52 weeks in adolescent and adult subgroups from three phase 3 studies. Patients were randomized to UPA 15 mg (UPA15), UPA 30 mg (UPA30) or PBO orally once daily, either alone or with concomitant topical corticosteroids. After 16 weeks, patients in the PBO group were randomized to the UPA15 or UPA30 groups. For both adolescent and adult subgroups at 52 weeks, the proportion of responders in the UPA15 and UPA30 groups was: ≥70% and 83% for EASI75, ≥31% and 47% for vIGA-AD 0/1 and ≥37% and 61% for Worst Pruritus Numeric Rating Scale improvement ≥4. Children’s Dermatology Life Quality Index (CDLQI) 0/1 was achieved by ≥15% (UPA15) and ≥28% (UPA30) of adolescents aged 12 to &amp;lt;16 years; DLQI 0/1 was achieved by ≥18% (UPA15) and ≥38% (UPA30) of adolescents aged 16 to &amp;lt;18 years and ≥30% (UPA15) and ≥45% (UPA30) of adults. Hospital Anxiety and Depression Scale (HADS-A and HADS-D) &amp;lt;8 was achieved in ≥28% of adolescents and ≥45% of adults for both treatment groups. Rates of serious adverse events (AEs) and serious AEs leading to discontinuation at week 52 were similar for both adolescents and adults. UPA15 and UPA30 responses in moderate-to-severe AD across 52 weeks were similar between adolescents and adults, with acceptable safety outcomes in both populations.

Dupilumab improves patient-reported symptoms and health-related quality of life in children aged 6-11 years with severe atopic dermatitis.

This was a post-hoc analysis of patient-reported outcomes from the LIBERTY AD PEDS randomized, double-blind, placebo-controlled, phase III trial of dupilumab + topical corticosteroids (TCS) in 367 children aged 6–11 years with severe atopic dermatitis (AD). At week 16, significantly more patients treated with dupilumab vs. placebo achieved a Patient-Oriented Eczema Measure (POEM) score of 0/1 (‘clear skin’/‘almost clear skin’), and significantly more reported Children’s Dermatology Life Quality Index (CDLQI) scores of 0/1 (‘no effect on life’). Significantly more patients achieved a minimal clinically important difference (≥ six-point reduction) in POEM and in CDLQI. Dupilumab (vs. placebo) + TCS resulted in clinically meaningful improvements in patients’ assessment of AD symptoms and quality of life.