Dermatology-specific Quality Of Life Research Articles

Mindful self-compassion for psychological distress -associated with skin conditions: An online intervention study.

Background Chronic skin conditions are different from internal illnesses since they are often immediately visible to others. Patients feel self-conscious and often go through depression, anxiety, fear of stigma and a substantial psychological, social and economic impact. It is crucial for healthcare professionals to gather information about various strategies and psychosocial interventions that can be used to manage psychological distress associated with skin conditions and avoid it from being neglected amidst other health conditions. Mindful Self-Compassion (MSC) can be used for this. It is a resource-building mindfulness-based self-compassion training programme that uses a combination of personal development training and psychotherapy designed to enhance one's capacity for self-compassion by cultivating spacious awareness as a basis for compassionate action. Aims This study examined the impact of mindful self-compassion on depression, anxiety, stress, dermatology-specific quality of life, self-esteem and well-being in a sample of 88 adults aged 18-55 years suffering from chronic skin conditions. Methods This study used an experimental waitlist control design. Participants were recruited from two skin clinics using purposive sampling in Mumbai, Maharashtra. Pre-test data was collected through self-reported questionnaires on psychological distress, dermatology-specific quality of life, self-esteem and well-being. Participants who were experiencing psychological distress were randomly assigned to either the experimental or waitlist control group. The intervention named 'mindful self-compassion' was delivered through an online platform, twice a week, over a period of 4 weeks. Post-test data was collected later on all variables. Results ANCOVA was utilised where pre-test scores were used as covariates. Differences in pre-test and post-test scores between the intervention group and waitlist control group for depression, anxiety, stress, dermatology-specific quality of life, self-esteem and well-being were analysed. Participants in the intervention group were found to have lower levels of depression, anxiety and stress as compared to the waitlist control group and also had enhanced levels of self-esteem, well-being and dermatological quality of life. These differences were found to be statistically significant (p < 0.001). Limitations The sample reflected heterogenous skin conditions, not a specific skin condition. The study was quantitative in nature, and we could not use any qualitative methods to assess the subjective experience of participants. Due to time constraints, follow-up data could not be gathered from participants to assess long-term effects on participants. Conclusion Mindful self-compassion can be effectively used to manage psychological distress in skin conditions. Dermatologists can become acquainted with basic signs of mental distress and the importance of psychological interventions. By collaborating with mental health professionals, patients can be given holistic treatment.

Ixekizumab Real-World Effectiveness at 24 Weeks in Patients with Psoriasis: Data from the United States Taltz Customer Support Program.

Ixekizumab, a highly selective interleukin-17A monoclonal antibody, was approved for the treatment of moderate-to-severe psoriasis (PsO) in 2016. Limited real-world data are available on its effectiveness from a patient's perspective shortly (2 to 4 weeks) after initiation and upon continuation for 24weeks. To describe patient-reported clinical and quality-of-life outcomes after initiating ixekizumab using data collected from the United States Taltz® Customer Support Program. This was a 24-week prospective, observational study of commercially insured diagnosis-confirmed adults with PsO. Surveys were completed at weeks 0 (baseline), 2, 4, 8, 12, and 24 and included the Patient Report of Extent of Psoriasis Involvement questionnaire to assess the extent of body surface area (BSA) affected by PsO, itch and pain numeric rating scales, Patient Global Assessment of Disease Severity (PatGA), and Dermatology Life Quality Index (DLQI). 523 patients were included in the analysis. Proportions of patients with ≤ 2% BSA involvement were 34.5%, 40.1%, 50.9%, and 79.9% at weeks 0, 2, 4, and 24, respectively; 54.8% and 75.1% achieved National Psoriasis Foundation preferred (BSA ≤ 1%) and acceptable (BSA ≤ 3% or ≥ 75% improvement) responses at week 12, respectively. Improvements of ≥ 4 points in itch and pain were seen by week 2 in 21.1% and 28.0% of patients, respectively, which increased to 63.1% and 64.8% at week 24. Proportions of patients with PatGA scores of 0 (clear) or 1 were 13.4%, 24.1%, 34.0%, and 69.6% at weeks 0, 2, 4, and 24, respectively; and proportions with DLQI total scores of 0 or 1 [no or minimal impact] were 8.4%, 17.6%, 27.3%, and 53.8% at weeks 0, 2, 4, and 24, respectively. Patient-reported improvements in BSA, itch, skin pain, dermatology-specific quality of life, and overall PsO severity were seen as early as 2weeks after initiation and continued through week 24.

351 Examining the relationships among abrocitinib treatment, itch, skin pain and dermatology-specific quality of life in patients with atopic dermatitis: a mediation modelling analysis

Abstract Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with itch, eczematous lesions and impaired quality of life (QoL). Although the frequency of skin pain in AD is often underestimated, it is associated with a substantial health burden, similar to itch and is known to contribute to sleep disruption and mood disturbance. Abrocitinib is an oral, once-daily, selective Janus kinase-1 inhibitor approved for the treatment of moderate-to-severe AD. In phase 3 clinical trials JADE MONO-1 (NCT03349060) and JADE MONO-2 (NCT03575871), abrocitinib demonstrated rapid relief from itch and skin pain, as well as meaningful improvements in QoL compared with placebo. The interrelationships between abrocitinib treatment and improvements in itch, skin pain and QoL have not yet been investigated. This mediation analysis aimed to characterize the effect of abrocitinib treatment via itch and skin pain on dermatology-specific QoL in patients with AD. Data from JADE MONO-1 and JADE MONO-2 were pooled in this analysis. Adult patients with moderate-to-severe AD received abrocitinib (200 or 100 mg) as monotherapy or placebo for 12 weeks. Three separate models were evaluated whereby QoL was assessed using the Dermatology Life Quality Index (DLQI) score, and itch and skin pain were assessed via the Pruritus and Symptoms Assessment for Atopic Dermatitis (PSAAD) items #1 (How itchy was your skin over the past 24 h?) and #2 (How painful was your skin over the past 24 h?), respectively. The cross-sectional mediation model (CSMM) was run separately at weeks 2, 4, 8 and 12 using all available data at each timepoint. The longitudinal mediation model (LMM), which does not assume independence among measurements of itch, skin pain and DLQI at each timepoint, estimated relationships using all available data from all weeks simultaneously. Based on the results of the CSMM and LMM, a pseudo-steady-state model, in which the relationship among variables was assumed to be the same across timepoints, was applied. Effects with P &amp;lt; 0.05 were considered statistically significant. In the CSMM, the indirect effect of abrocitinib on DLQI mediated via itch was considered approximately stable (24–30%) for the first 8 weeks before increasing at week 12 (42%), while the indirect effect mediated via skin pain was considered approximately stable from week 2 to week 12 (33–41%). In the LMM, the indirect effect of abrocitinib treatment on DLQI mediated via both itch and skin pain was considered approximately stable from week 2 to week 12 (17–26% and 42–48%, respectively). The cross-sectional and longitudinal models were generally consistent and indicated a pseudo-steady-state period between weeks 2 and 12. Using the pseudo-steady-state model, the direct effect of abrocitinib on DLQI was estimated to be 34.8% (P &amp;lt; 0.0001), and the indirect effects mediated via itch and skin pain were estimated to be 19.5% and 45.8%, respectively (P ≤ 0.0001 for both). Improvements in dermatology-specific QoL with abrocitinib are mostly mediated indirectly via a reduction in skin pain and less so by relief of itch. These findings warrant further research to examine to what extent patients consider itch and skin pain as separate concepts in terms of their impact on dermatology-specific QoL.

Quality of Life in Cutaneous T-cell Lymphoma Patients Receiving Mogamulizumab: Important Factors to Consider.

Erythrodermic cutaneous T-cell lymphoma (E-CTCL) is associated with a poor prognosis and severe symptoms. To establish insights into the quality of life (QoL), expectations, and treatment satisfaction of E-CTCL patients receiving mogamulizumab. Outcomes of this prospective cohort study conducted between September 2020 and August 2021 at the Leiden University Medical Center included the dermatology-specific QoL (Skindex-29), health-related QoL (RAND-12), degree of itch, pain, and fatigue (Visual Analogue Scale), patient's expectations, and treatment satisfaction (Client Satisfaction Questionnaire-8 (CSQ-8)), measured at baseline and after six months. 13 patients with E-CTCL were included. Most patients anticipated a positive treatment effect on symptoms. Five patients (46%) improved one or more clinical categories regarding the symptoms domain, six (55%) regarding emotions, four (36%) regarding functioning, and four (36%) regarding the overall Skindex-29 score compared to baseline. The Mental Component Score clinically improved from 31 (IQR 29-51) at baseline to 38 (IQR 25-51). The median VAS itch improved significantly from baseline (8 (IQR 7-10) vs. 3 (IQR 1-8), p = 0.024). Most patients (n = 7) were "very satisfied" with their treatment. There was a limited number of patients due to the rarity of the disease. In general, mogamulizumab has a favorable effect on biochemical- and dermatology-specific QoL and physical functioning in some patients, with high treatment satisfaction. Itch especially improved over time in most patients. The treatment satisfaction was generally high. Mogamulizumab seems to be an effective treatment that improves the QoL in patients with E-CTCL.

35064 Understanding the impact of depression on outcomes for patients with psoriasis: Results from a national survey

Depression represents a serious issue among individuals with psoriasis, who experience higher rates of depression than the general adult population in the United States. This study sought to assess the impact of depressive symptoms on the quality of life of individuals with psoriatic disease. A cross sectional study consisting of an online survey of a random stratified sample of individuals with psoriatic disease in the United States. A total of 1405 individuals completed the survey. Skin disease severity was assessed using the Patient Report Extent of Psoriasis Involvement (PREPI). Presence of depressive symptoms was assessed using the Patient Health Questionnaire (PHQ-2). PHQ-2 score ≥3 indicated presence of depressive symptoms. ANCOVA (STATA SE version 9) was conducted to control for severity of skin disease, age, sex, and disease type (PsO only or PsA) while comparing effect of having depressive symptoms on the following outcome measures: 1) dermatology-specific quality of life (DLQI); 2) PROMIS ability to participate in social roles and activities (SF-4a); and 3) global quality of life. After controlling for severity of skin disease, age, sex, and disease type, compared with individuals without depressive symptoms, individuals with depressive symptoms reported higher DLQI score (M = 4.97, SD = .16 v. M = 8.08, SD = .30, P < .001), lower t-scores for ability to participate in social roles and activities (M = 50.1, SD = .26 v. M = 41.7, SD = .44, P < .001) and poorer global quality of life (M = 4.37, SD = .08 v. M = 6.53, SD = .13, P < .001). These results suggest that depressive symptoms negatively impact outcomes for patients with psoriasis regardless of severity of skin disease.

34524 The association between patient-reported outcomes skin flaring in autoimmune blistering diseases

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.

Quality of life in patients with early- and late-onset hidradenitis suppurativa.

Hidradenitis suppurativa (HS) usually has an early onset, however, also onset in the mid-40s may occur. Recently, the threshold of 28years to distinguish patients with early and late onset has been proposed. The objective of our study was to compare the quality of life (QoL) and psychological distress in early- and late-onset HS patients. In this cross-sectional, observational study, consecutive patients diagnosed with HS aged ≥ 16years were recruited. Dermatology-specific QoL was evaluated using the Skindex-17 questionnaire, and psychological distress using the 12-item General Health Questionnaire (GHQ-12). Patients were categorized into "early onset" (< 28years) and "late onset" (≥ 28years). Data were collected on 467 patients. Mean age at diagnosis was 21.6years, with 22.0% of patients presenting with late disease onset. Patients with late onset reported worse psychosocial QoL and higher psychological distress compared to early onset. No differences between the two groups were observed for clinical severity. In the final multivariate model lower diagnostic delay, higher number of fistulae, higher BMI, ex-smoker, no localization on axillae, no localization on mammary region, presence of psoriasis, and higher scores on the psychosocial scale of Skindex-17 were statistically significantly associated with late onset. In conclusion, the psychosocial impact of HS is higher in patients with late onset compared to those with early onset. Differences between these two groups should be further investigated.

Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator

BackgroundCutaneous T-cell lymphoma (CTCL) is a chronic and progressive disease that has a major impact on quality of life (QoL).ObjectivesTo describe the impact of the different stages of disease in patients with classical mycosis fungoides, folliculotropic mycosis fungoides, and Sézary syndrome on generic- and dermatology-specific QoL and the relation with itch.MethodsA cross-sectional cohort study of patients with classical mycosis fungoides, folliculotropic mycosis fungoides, and Sézary syndrome was performed. Outcomes were the Skindex-29 score, Impact of Chronic Skin Disease on Daily Life which includes a visual analogue scale itch, and RAND-12.ResultsOne hundred six patients with CTCL were included. Compared to the total mycosis fungoides group, patients with Sézary syndrome had significantly worse Skindex-29 scores. Patients with advanced disease had statistically higher scores for the symptom (P = .007), functioning (P = .002), and total score (P = .012). The degree of itching was strongly correlated with the total Skindex-29 score (R = 0.713, P < .001).ConclusionThe different stages of CTCL can have a significant effect on multiple domains of generic- and dermatology-specific QoL. Itch was strongly correlated with QoL and therefore can be used as an overall QoL indicator. The effect on QoL, even in patients with early-stage disease, should not be underestimated.

199 Using Skindex-16 scores to predict skin flaring in autoimmune blistering diseases

Background: Chronic relapsing-remitting dermatologic diseases like autoimmune bullous diseases (ABDs) have significant impacts on quality of life (QOL). Monitoring these impacts regularly with patient-reported outcome (PRO) measures, like Skindex-16 can not only aid clinician-patient communication but also track treatment success and identify skin flares requiring intervention. Methods: Skindex-16 is a dermatology-specific QOL measure to assess skin disease impact on symptoms, emotions, and functioning (range 0-100, higher scores=greater impact).

Economic assessment of a community-based care package for people with lower limb disorder caused by lymphatic filariasis, podoconiosis and leprosy in Ethiopia.

We conducted an implementation research study to integrate a holistic package of physical health, mental health and psychosocial care for podoconiosis, lymphatic filariasis and leprosy into routine healthcare in Gusha cluster, Guagusa Shikudad district, northwest Ethiopia. The healthcare package included training patients in lower limb hygiene and skin care and provision of shoes, hygiene supplies and medication. The implementation activities included training events, workshops, awareness raising, self-help groups, supportive supervision, staff secondments and advisory board meetings. The cost of implementing the care package in Gusha cluster, with a population of 30 558 people, was 802 655 Ethiopian birr (ETB) (£48 159) and the cost of delivering care to 235 participants was 204 388 ETB (£12 263), or 870 ETB (£52) per person. There was a 35% decrease in the mean disability scores (measured using the World Health Organization Disability Assessment Schedule 2.0) and a 45% improvement in the dermatology-specific quality of life (measured using the Dermatology Life Quality Index) at the 3-month follow-up compared with baseline. There were reductions in the number of days with symptoms, days off usual activities/work and days with reduced activity due to illness, all of which were statistically significant. Our pilot suggests that integration of the care package into routine healthcare in Ethiopia may be effective in improving health-related quality of life and disability and reducing time out of economic activity due to illness.

Improvement in the quality of life of patients with rhododendrol-induced leukoderma after camouflaging with dihydroxyacetone cream.

Improvement in the quality of life of patients with rhododendrol-induced leukoderma after camouflaging with dihydroxyacetone cream.

Quality of life in patients with vitiligo

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Vitiligo is an acquired disorder characterized by well circumscribed depigmented macules and patches that result from a progressive loss of functional melanocytes. In India and perhaps elsewhere also patients with vitiligo have severe psychological and social problems. Quality of life is multidimensional index of different social, behavioural and cultural factors. Different tools were developed for measuring quality of life focusing on different conditions and diseases. The dermatology life quality index (DLQI) questionnaire is designed for use in patients of age more than 16. It can be used to measure the impact of vitiligo on quality of life. To assess the dermatology specific quality of life in patients with vitiligo. To study impact of vitiligo on their quality of life.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; In this study 150 patients diagnosed with vitiligo during a 1-year period were included. DLQI was calculated for every patient. &lt;strong&gt;&lt;/strong&gt;&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; The mean DLQI score in our study was 6.14. There was a statistically significant difference in mean DLQI of unmarried as compared to married. There were no statically significant differences in other groups. Out of 150 patients of vitiligo, 3 (2%) patients had no effect, 66 (44%) patients had small effect, 69 (46%) patients have moderate effect, while 12 (8%) patient had very large effect of vitiligo on their quality of life.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Vitiligo affects quality of life in majority of patients. So, it should be treated aggressively with various treatment modality along with proper counselling and psychological support.&lt;/p&gt;

Clinical severity measures and quality-of-life burden in patients with mycosis fungoides and Sézary syndrome: comparison of generic and dermatology-specific instruments.

Given the severe symptom burden and chronic nature of mycosis fungoides (MF) and Sézary syndrome (SS), effective assessment of quality of life (QoL) is essential to guiding patient-centred care in this population. In this study, we aim to provide a comprehensive assessment of QoL in early- and advanced-stage MF/SS and to assess the correlation of traditional measures of clinical severity with QoL measures. Between July 2017 and April 2019, outpatients at an academic medical centre with either MF/SS (n=115) or general dermatology concerns (n=115) completed generic and dermatology-specific QoL instruments [Health Utilities Index Mark 3 (HUI3), RAND 36-Item Short-Form Health Survey (SF-36), Skindex-29, visual analogue scale for itch (VAS itch) and 5-D pruritus scale]. The mean scores of MF/SS patients were compared to that of controls using multivariable regression models adjusted for demographics and medical comorbidities. Cluster analysis of the QoL instruments and clinical severity measures (e.g. stage and body-surface-area involvement) was performed. Patients with MF/SS scored significantly worse than controls on all QoL instruments used, with advanced-stage (IIB-IVB) disease having the worst QoL impairment. Early-stage (IA-IIA) and advanced-stage MF/SS patients had significantly reduced overall health status (HUI3; P<0.05), with largest decrements in social functioning and usual role functioning due to physical and emotional health (SF-36; all P<0.05). MF/SS had significantly worse skin-specific impairment than controls, with advanced-stage disease reporting the most severe skin-specific burden (Skindex-29, P<0.05). Clinical severity measures had a weak correlation with generic (|rs |=0.02-0.27) and moderate correlation with dermatology-specific instruments (|rs |=0.41-0.53). MF/SS have a significant impact on multiple domains of patients' QoL, including social, emotional and physical functioning. Current clinical measures do not adequately address QoL outcomes, underscoring the need for integrating formal disease-specific QoL assessment into the routine evaluation of MF/SS patients.

Effectiveness of an Integrative Body-Mind-Spirit group intervention in improving the skin symptoms and psychosocial well-being in children living with atopic dermatitis: A randomized-waitlisted controlled trial

ObjectiveThe symptomatology of atopic dermatitis (AD) imposes heavy physical, psychological, and social burdens on children, yet their psychosocial needs have been commonly ignored in AD management. Evidence of the psychosocial effects of psychosocial interventions on childhood AD is thin. The present study aimed to examine the effects of a customized Integrative Body-Mind-Spirit (IBMS) group intervention on physical, psychological, and social outcomes for children with AD. MethodsA randomized-waitlisted controlled trial was conducted. Children of primary-school age who had been diagnosed with AD and their parents were recruited. Parent-child dyads were randomized to either the IBMS group or waitlisted controlled (WLC) group. Children and their parents attended six three-hour sessions incorporating treatment components based on the IBMS intervention model. The group intervention was conducted in parallel format that the children and parents attended independently of each other. Outcome measures included the severity of AD, generalized and social anxiety symptoms, emotion regulation, self-esteem, quality of relationships with parents, and dermatology-specific quality of life (QoL) at pre-intervention (T0), post-intervention (T1) and 5-weeks post-intervention (T2). ResultsData from 58 children in the IBMS group and 55 children in the WLC group were analyzed. There were no differences in baseline measures. Children in the IBMS group displayed significant decrease in severity of AD, generalized anxiety and social phobia, and improvement in emotion regulation as compared with the WLC group. No significant difference in self-esteem, quality of relationships with parents, or dermatology-specific QoL between the two groups was found. ConclusionWith a rigorously designed evaluation, the study found that the IBMS parallel-group intervention based on a holistic perspective and Eastern philosophies on health and well-being was effective in improving skin symptoms and psychosocial well-being among 6–12-year old children living with AD. Future research needs to customize this IBMS intervention to other developmental stages of children with AD in other geographical contexts so as to benefit wider populations.

Compassion-focused self-help for psychological distress associated with skin conditions: a randomized feasibility trial

Objective: This study tested the feasibility of a self-help intervention based on Compassion-Focused Theory (CFT), and estimated treatment effects in a population of adults with skin conditions and associated psychological distress.Design: A randomized-controlled design was used, with 176 participants being allocated to either CFT-based self-help or a waitlist control group, who received usual medical care. The two-week intervention was provided by email.Main Outcome Measures: Treatment adherence and attrition rates were calculated, and effectiveness was estimated using measures of perceived stress, anxiety, depression, dermatology-specific quality of life and self-compassion.Results: Eighty-seven participants completed the post-intervention questionnaires (51%), and practiced on a median of 9/14 days. Study completers demonstrated significant, moderate improvements on measures of stress, anxiety, depression, self-compassion and dermatology-specific quality of life, relative to controls. In intention-to-treat (ITT) analyses, these findings remained significant, however effect sizes reduced from moderate to small.Conclusions: The findings indicate that CFT self-help shows promise in the treatment of psychological distress associated with skin conditions, however further testing of the intervention is not feasible without significant methodological changes, including the method of treatment delivery. Future studies should also include a follow-up period, as the duration of treatment effects could not be shown.

STRIA GRAVIDARUM;

Striae gravidarum (SG) is a physiological skin change that many pregnant women experience during pregnancy. Striae gravidarum seems to be undesirable to many pregnant women but its impact on women’s life is unclear. It is a disfiguring change on the skin of pregnant women presenting atrophic linear scars. They may occur anywhere on the body, though the abdomen, breasts, hips and legs are common. This change has a deep impact on the psychology and quality of life (QoL) of women. The quality of life of pregnant women deteriorates with distressing body image, causing psychological problems.The aim of this study is to evaluate the impact of striae gravidarum on the dermatology-specific quality of life (QOL) of pregnant women. Objectives:To evaluate the impact of Stria gravidarum on the dermatology - specific qualoty of life (QOL) among pregnant women.Method:A multi-disciplinary cross-sectional study was conducted among the pregnant women attending the outpatient department at Dow university hospital for antenatal visits in third trimester. Striae gravidarum was assessed by using Dave’s score. After taking informed consent, Skindex 16 dermatology specific QOL questionnaire was used to evaluate the QOL. Data was analyzed by using SPSS version -16. Using Mann Whitney level of significance &lt;0.05.Study Design:A cross sectional study. Duration of Study: January 2016 till January 2017. Place of Study: Department of Dermatology and department of Gynecology, Dow University Hospital, Dow International Medical College (Ojha Campus), DUHS, Karachi.Result:Among 112 pregnant women striae gravidarum was present in 32(28.6%) in primigravida, and 80(71.4%) in multigravida.Severity of striae gravidarum was assessed by using Davey’s score. Pregnant women with severe striae gravidarum showed significantly higher scores on emotion of Skindex-16 compared with those with absent or mild striae gravidarum. Conclusion:It is concluded that due to Striae gravidarum, pregnant females worry more with greater concern regarding their appearance. Their interaction with others was found to be highly affected due to this disfiguring physical change. The symptoms, emotional well-being and functionality differed significantly when the women with mild SG were compared with those with severe SG, though no difference was observed when primiparae subjects were compared with multipara subjects.The occurrence and severity of striae gravidarum influenced their dermatology-specific QOL and it is important to prevent or reduce the severity of striae gravidarum.

Conceptualization, development and validation of T-QoL© (Teenagers' Quality of Life): a patient-focused measure to assess quality of life of adolescents with skin diseases.

Skin disease can affect the quality of life (QoL) of teenagers in a variety of different ways, some being unique to this age group. To develop and validate a dermatology-specific QoL instrument for adolescents with skin diseases. Qualitative semistructured interviews were conducted with adolescents with skin disease to gain in-depth understanding of how skin diseases affect their QoL. A prototype instrument based on the themes identified from content analysis of interviews was tested in several stages, using classical test theory and item response theory models to develop this new tool and conduct its psychometric evaluation. Thirty-three QoL issues were identified from semistructured interviews with 50 adolescents. A questionnaire based on items derived from content analysis of interviews was subjected to Rasch analysis: factor analysis identified three domains, therefore not supporting the validity of T-QoL as a unidimensional measure. Psychometric evaluation of the final 18-item questionnaire was carried out in a cohort of 203 adolescents. Convergent validity was demonstrated by significant correlation with Skindex-Teen and Dermatology Life Quality Index (DLQI) or Children's DLQI. The T-QoL showed excellent internal consistency reliability: Cronbach's α = 0·89 for total scale score and 0·85, 0·60 and 0·74, respectively, for domains 1, 2 and 3. Test-retest reliability was high in stable volunteers. T-QoL showed sensitivity to change in two subgroups of patients who indicated change in their self-assessed disease severity. Built on rich qualitative data from patients, the T-QoL is a simple and valid tool to quantify the impact of skin disease on adolescents' QoL; it could be used as an outcome measure in both clinical practice and clinical research.

Secukinumab provides sustained improvements in dermatology-specific quality of life in moderate to severe psoriasis patients through 3 years of treatment: Results from the SCULPTURE extension study

Secukinumab provides sustained improvements in dermatology-specific quality of life in moderate to severe psoriasis patients through 3 years of treatment: Results from the SCULPTURE extension study

Current Quality-of-Life Tools Available for Use in Contact Dermatitis.

Contact dermatitis is a common dermatologic condition that can cause significant impairment in patients' overall quality of life (QoL). This impact is separate and potentially more clinically relevant than one's disease "severity" in contact dermatitis and should be consistently addressed by dermatologists. Despite this, QoL tools specific to contact dermatitis are lacking, and there is little consistency in the literature regarding the tool used to evaluate clinical response to therapies. Measurements currently available to evaluate disease-related QoL in contact dermatitis fit into 1 of the following 3 general types: generic health-related QoL measures, dermatology-related QoL measures, or specific dermatologic disease-related QoL measures. This article reviews the strengths and weaknesses of existing QoL tools used in contact dermatitis including: Short Form Survey 36, Dermatology Life Quality Index, Skindex-29, Skindex-16, Dermatology-Specific Quality of Life, and Fragrance Quality of Life Index.

Photobiomodulation for the management of radiation dermatitis: the DERMIS trial, a pilot study of MLS(®) laser therapy in breast cancer patients.

The aim of this study was to assess the effectiveness and acceptability of photobiomodulation using MLS(®) laser therapy (LT) in the management of acute radiation dermatitis (RD). We compared two successive groups of breast cancer patients undergoing identical radiotherapy regimens post-lumpectomy. Both groups received our standard skin care but the second group received six additional LT sessions (beam area 19.635cm(2), 0.168W/cm(2), 4J/cm(2)), starting at fraction 20 of radiotherapy (control and LT group, N = 41 and 38, respectively). The clinical outcomes were the severity of RD (using the Radiation Therapy Oncology Group [RTOG] criteria and the Radiotherapy-Induced Skin Reaction Assessment Scale [RISRAS]) and dermatology-specific quality of life (Skindex-16) before the start of LT and at the end of radiotherapy. Secondary outcomes were patients' ratings of skin care or LT (pleasantness, soothing effect, and global satisfaction). Skin toxicity was equivalent between the groups before the start of LT but significantly differed at the end of radiotherapy, with an aggravation in the control but not in the LT group (e.g., 29 versus 3% of RTOG grade 2 RD, respectively, P < 0.005). We found no significant group differences with respect to quality of life. However, the RISRAS subjective score decreased in the LT group only, implying a decreased impact of RD on patients' quality of life. Finally, patients' ratings were significantly higher for LT than for standard care. These findings suggest that LT might be effective to manage acute RD and warrant further research. NCT01932073. https://clinicaltrials.gov/ct2/show/NCT01932073 .