Higher Dermatology Life Quality Index Scores Research Articles

Evaluating the Clinical Meaning of Dermatology Life Quality Index Scores Between Different Phenotypes of Atopic Dermatitis in Patients Before and After Biologic Therapy With Dupilumab.

Background and Objective: Atopic Dermatitis (AD) is the most prevalent inflammatory skin disorder resulting in an intense impact on patients quality of life. The aim of this study is to evaluate the clinical meaning of the DLQI scores documented between different phenotypes of AD patients under biologic therapy with Dupilumab. Method: We conducted a retrospective analysis of 209 patients with AD treated with Dupilumab for 2 years. These patients were categorized into different clinical phenotypes. Severity of the disease was assessed by using the Eczema Area and Severity Index (EASI), Numerical Scale Rating (NRS) for sleep (NRS sleep), pruritus (NRS pruritus) and Dermatology Life Quality Index (DLQI) at baseline and subsequently at 4,12 and 24 months. Results: Our results show that the higher DLQI scores (mean: 18.6, range:9-30) achieved at T0 are associated with a prurigo nodularis AD pattern, while after 24 months (T3) of therapy with Dupilumab, the worst quality of life index results were reported in Flexural and Head-Neck combined clinical phenotypes. Conclusions: Quality of life is probably what matters most as an overall endpoint in AD. Assessing the clinical meaning of DLQI scores across different AD phenotypes could be a further aid when considering decision making factors in patient management.

The comparative burden of chronic spontaneous urticaria, atopic dermatitis and psoriasis in five European countries

AbstractBackgroundSkin diseases can have a significant impact on the physical, psychological and social well‐being of patients. Quantification of the burden of chronic spontaneous urticaria (CSU) compared to other dermatological conditions is limited.ObjectivesTo evaluate the comparative humanistic and economic burden of CSU, atopic dermatitis (AD), and psoriasis (PSO) in five European countries (EU5).MethodsThis cross‐sectional analysis compared data from adult respondents with a physician diagnosis of CSU, AD and PSO from the 2020 National Health and Wellness Survey in EU5 (France, Germany, Italy, Spain and the United Kingdom). Outcomes included Short Form (SF)‐12v2 [mental (MCS) and physical component (PCS) summary scores], SF‐6D, EQ‐5D, EQ‐Visual Analogue Scale (VAS), Dermatology Life Quality Index (DLQI), General Anxiety Disorder‐7 (GAD‐7), Patient Health Questionnaire‐9 (PHQ‐9), Work Productivity and Activity Impairment (WPAI) and healthcare resource utilization (HRU). Multivariable analyses comparing CSU to AD and PSO, respectively, were conducted for each outcome.ResultsThis analysis included 379 CSU, 788 AD and 2,636 PSO patients. Adjusted MCS and PCS scores were lower among CSU patients than AD (MCS, p = 0.006; PCS, p < 0.001) and PSO (p < 0.001 for all). SF‐6D and EQ‐5D scores were consistently lower among CSU patients versus AD and PSO (p < 0.001 for all), whereas the EQ VAS was lower in CSU cohort versus PSO cohort (p = 0.003). Higher DLQI scores were reported in the CSU cohort versus AD and PSO (p < 0.001 for both) and the proportion of patients with anxiety and depression, respectively, (GAD‐7 and PHQ‐9 scores ≥5) was greater among the CSU cohort versus AD and PSO (p < 0.001 for all). Finally, higher HRUs and worse WPAI scores (p < 0.005) were observed in the CSU cohort relative to AD and PSO cohort.ConclusionsCSU is associated with significantly worse health‐related quality of life, more mental comorbidities, negative impact on patients' daily lives and the ability to work, ultimately leading to higher HRU compared with AD and PSO.

Burden of vitiligo on Chinese patients: an online survey.

Burden of vitiligo on Chinese patients: an online survey.

Effects of Biologics on Mental Health and Health-Related Quality of Life in Patients With Psoriasis: A Repeated Cross-Sectional Survey in Chinese Population

Objective: Psoriasis is a chronic inflammatory systemic disease that severely impacts patients’ quality of life (QoL) and psychological health. While biologics have been shown to be effective in treating psoriatic lesions, thus improving QoL, real-life data regarding such effects remain scant. We administered a repeated cross-sectional survey to assess the effects of 8 weeks of biologics treatment on the QoL and mental health status of patients with moderate-to-severe plaque psoriasis. Methods: From March to May 2022, patients with moderate-to-severe plaque psoriasis were enrolled and treated with biologics in the outpatient clinic at the Dermatology Hospital of Southern Medical University. Assessments were performed before treatment and after 4 and 8 weeks of treatment with biologics. Psoriasis severity, QoL, and mental health status were evaluated using the Psoriasis Area and Severity Index (PASI), Dermatology Life Quality Index (DLQI), 36-Item Short-form Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS). A multivariate generalized estimating equations (GEE) analysis was used to account for repeated measures and to determine the effects of treatment duration and type of biological agent on relevant indicators. Results: Among the 78 enrolled patients, the ranges of pretreatment scores were 4.6 to 46.8 for the PASI, 1 to 30 for the DLQI, 31.5 to 100.0 for the physical component score (PCS) of the SF-36, 16.6 to 100.0 for the mental component score (MCS) of the SF-36, 0 to 15 for the HADS-A, and 0 to 17 for the HADS-D. After 8 weeks of biologics treatment, 98.7% (77/78) of patients had obtained PASI 75. All assessed scores changed over time (GEE, P < 0.001). Moreover, there were group-by-time interaction effects for the DLQI score (GEE, P = 0.023) and PCS (GEE, P = 0.029). The HADS-A and HADS-D scores were both decreased at week 8 compared with pretreatment values. Correlation analyses revealed that higher DLQI scores were associated with lower levels of QoL and higher levels of anxiety or depression. Conclusion: Biologics are not only effective in the treatment of skin lesions but also exert beneficial effects upon the QoL and mental health of patients with psoriasis as determined in the short-term assessments conducted in this study.

Societal costs and health related quality of life in adult atopic dermatitis

BackgroundCost-of-illness studies are widely used for healthcare decision-making in chronic conditions. Our aim was to assess the cost-of-illness of adult atopic dermatitis (AD) from the societal perspective in Hungary.MethodsWe conducted a multicentre, cross-sectional questionnaire survey between February 2018 and January 2021. Data was collected from consecutive AD patients aged ≥ 18 years and their physicians at dermatology departments in Hungary. We calculated direct and indirect costs, including costs for treatments, outpatient visits, hospital admissions, informal care, travel costs and productivity loss. To assess indirect costs, the Work Productivity and Activity Impairment (WPAI) questionnaire was used to collect data, and costs were estimated with the human capital approach. Generalized linear model was used to analyse predictors of total, direct and indirect costs.ResultsAltogether 218 patients completed the survey (57.8% female) with an average age of 31.3 (SD = 11.7). Patients’ average Dermatology Life Quality Index (DLQI) score was 13.5 (SD = 8.5). According to Eczema Area and Severity Index (EASI) score, 2.3% (n = 5), 21.2% (n = 46), 54.4% (n = 118) and 22.1% (n = 48) had clear, mild, moderate, and severe AD, respectively. We found that the average total, direct medical, direct non-medical and indirect annual costs per patients were €4,331, €1,136, €747, and €2450, respectively, with absenteeism and presenteeism being the main cost drivers, accounting for 24% and 29% of the total cost of AD. A one-year longer disease duration led to, on average, 1.6%, and 4.2% increase in total and direct non-medical costs, respectively. Patients with worse health-related quality of life (higher DLQI score) had significantly higher total, direct medical, direct non-medical costs, and indirect costs.ConclusionsOur results indicate a substantial economic burden of AD from a societal perspective, mainly driven by productivity losses.

Normative data and socio-demographic determinants of the Dermatology Life Quality Index in a large online sample of the Hungarian population

Background Population norms are available for several generic health-related quality of life questionnaires, but rarely for disease- or specialty-specific questionnaires. Objectives The aim of our study was to calculate population norms for the Dermatology Life Quality Index (DLQI) score. Methods We conducted an online self-completed questionnaire survey on a large sample of the general Hungarian adult population. Respondents’ socio-demographic characteristics and dermatology-related quality of life aspects were recorded. Results A total of 2,001 participants completed the questionnaire, with the average age of 48.2 (SD = 16.6) years, half of the respondents in our sample (n = 981) reported long-standing health problems. The average DLQI score was 1.9 (SD = 4.0) with women having a higher average (2.0, SD = 3.9) than men (1.8, SD = 4.0; p=<0.001). The DLQI score differed among age-groups with younger people having relatively higher DLQI averages. When the multivariate linear regression model was applied, it showed that young age, lower income and unemployment status were associated with higher DLQI scores, while controlling for the existence of skin disease (p<0.05). Conclusions This study esthablished DLQI population norms among the general population, which may provide a reference point in health-policy and financing decision-making.

Depression and anxiety among patients with psoriasis: A correlation with quality of life and associated factors

ObjectivesPsoriasis is a chronic, immune-mediated illness that primarily affects the skin, nails and joints. This illness may predispose people to mental disorders such as depression and anxiety. This study aims to determine the prevalence of depression and anxiety in patients with psoriasis and their correlation with quality of life and associated factors. MethodsThis cross-sectional study involved 174 patients with psoriasis at the dermatology clinic of Hospital Sultanah Bahiyah, Alor Setar. All patients were instructed to complete four sets of questionnaires relating to: sociodemographic profile, clinical characteristics of illness, the validated Malay version of Hospital Anxiety and Depression Scale (HADS) and the Malay validated version of Dermatology Life Quality Index (DLQI). Data were analysed using a descriptive analysis and correlational and multiple logistic regression analyses. ResultsWe have found that 8.5% patients had depressive and 16.9% had anxiety symptoms. Multiple logistic regression analysis showed that higher DLQI scores, presence of lower limbs' lesions and dyslipidaemia were associated with depression in the sampled population. ConclusionThis study has shown that the cohort with psoriasis exhibited notable symptoms of depression and anxiety. This emphasises the need for the assessment of anxiety and depression among patients with psoriasis as these symptoms predict poor quality of life. Such correlation of psoriasis with anxiety and depression essentially leads to psychological sequelae. Affected psoriasis patients need appropriate intervention. Our study paves the way for further research by involving other underlying constructs such as perceived body image and stigma.

Impact of skin, musculoskeletal and psychosocial aspects on quality of life in psoriatic arthritis patients: A cross-sectional study of outpatient clinic patients in the biologic treatment era

BackgroundIn psoriatic arthritis (PsA), both psoriasis and musculoskeletal manifestations may impair Health-Related Quality of Life (HRQoL). Our objective was to explore the impact of the various disease manifestations and disease...

Use of the Dermatology Life Quality Index work/study domain to estimate overall work productivity loss among patients with psoriasis: an analysis based on real-world data.

Psoriasis is a chronic autoimmune disease that is associated with substantial economic burden related to work productivity loss (WPL). WPL is commonly measured using the Work Productivity and Activity Impairment (WPAI) questionnaire. However, WPAI does not measure outcomes among unemployed patients, and may therefore underestimate the burden of psoriasis. This study evaluated the relationship between the Dermatology Life Quality Index (DLQI) questionnaire work/study domain and WPL using the WPAI, as DLQI assesses the impact of psoriasis on the ability to work/study regardless of employment status, but does not estimate WPL. Data were drawn from the Adelphi Psoriasis Disease Specific Programme survey. A positive linear relationship was observed between DLQI work/study scores and WPAI results, showing that higher DLQI scores were associated with greater percent WPL. These findings suggest that the DLQI work/study domain can be used to estimate overall WPL among patients with psoriasis, including those who cannot work because of their disease.

A Randomized Controlled Trial on the Use of Heparinoid Moisturizer for Improving Quality of Life with Acute Radiation Skin Damage from Radiation Therapy after Breast-Conserving Surgery

Heparinoid (HP) moisturizer application following radiation therapy increases water content in the stratum corneum and improves skin desquamation and dryness for radiation dermatitis caused by radiation therapy after breast-conserving surgery (BCT-RT). Improvement of dry skin by moisturizer application may also help to improve patient quality of life (QOL) in this setting. The aim of this study was to evaluate the effect of HP moisturizer use on quality of life in patients with acute radiation skin damage after BCT-RT. We performed a randomized controlled trial of a moisturizer group (Group P) and a no-moisturizer group (Group C) to examine whether HP application as moisturizer contributed to improvements in QOL among patients with radiation skin reaction due to BCT-RT. A total of 75 patients who received BCT-RT between October 2017 and September 2018 were randomly allocated in our hospital to Group P and Group C. Group P applied HP from the radiation start date, HP twice daily for 7 weeks. QOL was assessed using the Dermatology Life Quality Index (DLQI) at the radiation start date, and at Weeks 1, 2, 3, 4, 5 and 7 after the radiation start date. A higher DLQI score indicates a worse quality of life. The primary endpoint was mean total DLQI score at 4 weeks after the start date, with secondary endpoints of total DLQI score, DLQI subscores (Symptoms and feelings; Daily activities; Leisure; Work and school; Personal relationship; and Treatment score) at each time point. Radiation treatment was whole-breast irradiation (42.56 Gy in 16 fractions); with added tumor bed boost (10-15 Gy in 4-6 fractions) in 17 cases, according to our hospital protocol. Three cases dropped out, and 72 cases were analyzed (Group P, 35 cases; Group C, 37 cases). The mean (± standard deviation) DLQI total scores 4 weeks after the start date was 2.063±2.169 in Group P, and 2.233±2.161 in Group C. No significant difference between P and C groups was seen (Mann-Whitney U test, p=0.894). In both groups, the DLQI total score showed no significant change until 2 weeks after the start date, and significantly worsened from 3 weeks to 5 weeks after the start date. No significant difference was seen between groups at 7 weeks after the start date. In subscores, “Symptoms and feelings” showed changes similar to the total DLQI score, and no significant differences were seen between 7 weeks after the start date and start date only in the P group. DLQI scores were lower at all observation periods for “Daily activities,” “Leisure”, “Personal relationship,” and “Treatment.” In terms of DLQI total score, no significant improvement was obtained from moisturizer application 4 weeks after the start of radiation. Seven weeks after the start date, “Symptoms and feelings” were restored by moisturizer application to the baseline score at initiation. With hypofractionated irradiation, changes in QOL were minimal.

Solar urticaria in 145 patients: Assessment of action spectra and impact on quality of life in adults and children

Solar urticaria (SU) is a rare chronic inducible urticaria triggered via uncharacterized chromophores. We detail responses of a large patient series to monochromator phototesting and broadband ultraviolet radiation (UVR); relationship to life quality is explored. Retrospective review of all SU patients undergoing standardized diagnostic photoinvestigation at a specialist centre during 2000-2016. From 2011, patients completed dermatology life quality index (DLQI) questionnaires for the past week and year. In 145 patients (mean: 35.8, range: 3-69years; 18 aged <18years; 100 female), combined phototesting with broadband UVR and monochromator sources successfully provoked 74.5% patients, with 65.6% provoked by broadband UVR alone and 57.9% by monochromated radiation alone. The narrow wavebands most frequently eliciting wheal and flare response were between 370 and 400nm, with 25% patients at 300±5nm, 53.6% at 320±10nm, 66.7% at 330±10nm, 77.4% at 350±20nm, 83.3% at 370±20nm, 86.9% at 400±20nm, 44% at 500±20nm and 17.8% at 600±20nm. In 62 patients, the DLQI revealed 56.1% had very to extremely large impact in the past week (all patients: mean score: 11.1, range: 0-29) rising to 69.8% for the past year (12.5, 0-30); adults and children were similarly affected. Patients with positive photoprovocation had higher DLQI score than those who were negative (DLQI for past week: mean: 12.6±SEM 1.1 vs 4.6±1.4, P<.01). SU is predominantly provoked by longer UVA-shorter visible radiation, which penetrates window-glass and where sunscreens are less effective; impact on life quality is considerable. Photoprotective agents effective against this spectrum are needed.

Quality of life in mild and severe alopecia areata patients.

BackgroundAlopecia areata is a relapsing hair disorder characterized by a sudden hairloss and has a considerable impact on patient’s quality of life. The goal of this study was to determine quality of life among patients with mild and severe forms of alopecia areata and compare the two groups.MethodsDuring one year, 176 patients (96 mild, 80 severe) were selected and asked to complete Dermatology Life Quality Index (DLQI) questionnaires.ResultsOur study revealed that the severe group was predominantly female and had higher amount of unemployment, more prolonged disease duration, unstable disease course and facial involvement. The mean DLQI scores in the severe and mild groups were 10.7 ± 7.5 and 5.4 ± 6.8, respectively which was significantly different and severe group had higher DLQI scores and more quality of life impairment. As well, there was a significant association between total DLQI scores and acute stress during last 6 months.ConclusionsOur study confirms that alopecia areata considerably impacts quality of life and this is more pronounced in patients with severe disease and those who had acute stress recently.

Quality of life assessment in patients with alopecia areata and androgenetic alopecia in the People's Republic of China.

IntroductionIn medical terms, alopecia is considered a relatively mild dermatological condition that nevertheless is a serious condition, but it causes major depression in many sufferers. Alopecia areata (AA) and androgenetic alopecia (AGA) are the main types of hair loss. This study assessed the quality of life (QoL) of Chinese patients with AA and AGA using the Dermatology Life Quality Index (DLQI) questionnaire.MethodsA total of 178 AA and AGA patients were enrolled in this study, and DLQI was used to evaluate the QoL of the patients. The DLQI used 10 items regarding symptoms and feelings, daily activities, leisure, work and school, personal relationships, and treatment as dimensions of life. Each was scored on a 0–3 scale. The total DLQI score equaled 0–30; higher scores showed greater impact on QoL.ResultsThe DLQI scores of the 178 patients ranged from 0 to 28, with a mean score of 6.3. Higher DLQI scores were reported by younger patients (P<0.05) and by those who had hair loss for a duration of >12 months (P<0.05). The DLQI score of AA patients was significantly higher than that of AGA patients (P<0.05). QoL was not affected by gender, marital status, educational level, past history of alopecia, family history of alopecia, or severity of alopecia.ConclusionAA and AGA moderately affected the QoL of the patients. A higher DLQI score was significantly associated with younger age, hair loss for a duration of >12 months, and AA. Both AA and AGA moderately affected the QoL of the patients not only in physiological aspects but also in their emotional and social aspects. The bio-psycho-social aspects of disease need to be addressed in patients with AA and AGA, even though these conditions are not life-threatening.

Factors affecting patient presentation at a national dermatology referral clinic in Kampala, Uganda.

This study sought to gain a better understanding of the patient population in Kampala and was further designed to elucidate barriers that may delay individuals from receiving proper dermatologic care. The study took place at the dermatovenereology clinic of a tertiary care hospital in Kampala. New adult patients were surveyed in July and August of 2013. The primary dependent variable was time from reported onset of symptoms to presentation to the clinic. Participant demographic characteristics, medical and treatment history, and perception of illness as measured by the dermatology life quality index (DLQI) were assessed. A total of 232 subjects participated in the study. The most common skin diseases were allergic (20.3%), infectious (15.1%), follicular (7.8%), and papulosquamous (7.8%) disorders. Greater home distance from the clinic correlated with later presentation times (r = 0.259, P < 0.001). DLQI score was not correlated with presentation time. HIV+ individuals presented earlier (mean 5 vs. 11 months, P = 0.043) and had higher DLQI scores (mean 12.6 vs. 9.3, P = 0.006) than HIV- individuals. The majority of participants (72.5%) had contact with at least one other healthcare worker (HCW) for management of their dermatologic symptoms; 65.8% reported that these previous treatments were ineffective. Efforts to educate HCWs should be focused on districts outside of Kampala and highlight recognition and proper treatment of allergic diseases. HCWs should aggressively treat skin problems in HIV+ individuals. HCWs practicing in Kampala without formal dermatological training should refer patients with skin disease to the clinic, as patients may receive care that is more appropriate.

Satisfaction with current psoriasis treatment: misalignment between physician and patient perceptions

Psoriasis patients often report dissatisfaction with treatment. However, the extent to which patients and their treating dermatologists are aligned regarding satisfaction with psoriasis therapy is largely unknown. This was explored using data derived from the Adelphi 2011/2013 Psoriasis Disease Specific Programmes, two real world surveys of US dermatologists and their patients. Physicians and patients independently reported their satisfaction with psoriasis control (satisfied, dissatisfied). Two levels of satisfaction alignment between physician and patient responses were constructed: aligned (same responses) and misaligned (different responses). In addition, dermatologists provided patient treatment history and disease/symptom severity whereas patients reported data on health-related quality of life (HRQoL), using the EuroQOL 5-Dimension Health Questionnaire (EQ-5D) and Dermatology Life Quality Index (DLQI), and work productivity using the Work Productivity Activity index (WPAI). Multivariate regressions were employed to examine the relationship between satisfaction alignment, overall disease and symptom severity, HRQoL, and work productivity controlling for differences in patient demographics and comorbidities.From 627 paired dermatologist and psoriasis patient records, 512 (81.7%) and 115 (18.3%) cases fell into the 'aligned' and 'misaligned' groups, respectively. Compared with patients in the aligned group, those in the misaligned group had more moderate to severe psoriasis (82.3% vs. 43.7%), moderate to severe itching (45.6% vs. 27.8%), pain (23.0% vs. 10.6%), and scaling (54.8% vs. 36.1%), and had lower current biologics use (27.0% vs. 42%) (all p&lt;0.05). The misaligned group was associated with reduced HRQoL (lower EQ-5D score: 0.86 vs. 0.91; higher DLQI score: 7.06 vs. 4.23) and greater work productivity loss (higher WPAI scores: 18.27 vs. 11.43) (all p&lt;0.05). Multivariate analyses confirmed these results (p&lt;0.05). Almost 1 in 5 patients were misaligned with their dermatologist's level of satisfaction with their psoriasis treatment; misalignment was associated with increased disease and symptom severity, reduced HRQoL, and reduced work productivity.

Clinical Characteristics and Quality of Life of Seborrheic Dermatitis Patients in a Tropical Country.

Background:Seborrheic dermatitis is a common chronic inflammatory skin condition that can have a negative impact on a patient's quality of life. Few studies have been conducted to assess the clinical characteristics of the disease and quality of life of the patients, especially in tropical countries.Aims and Objectives:The aim of this study was to demonstrate the clinical characteristics and quality of life of patients with seborrheic dermatitis in Thailand.Materials and Methods:A cross-sectional study was performed at a university-based hospital and tertiary referral center in Bangkok, Thailand. The validated Thai version of the dermatology life quality index (DLQI) was used to evaluate patients’ quality of life.Results:A total of 166 participants were included. One hundred and forty-seven patients (88.6%) experienced multiple episodes of the eruption. The mean of outbreaks was 7.8 times per years, ranging from once every 4 years to weekly eruption. The most common factor reported to aggravate seborrheic dermatitis was seasonality (34.9%), especially hot climate. The mean (SD) of the total DLQI score was 8.1 (6.0) with a range of 0 to 27. There was no statistically significant difference between the two DLQI categories regarding duration of disease, extent of involvement, symptoms or course of the disease.Conclusion:Although mild and asymptomatic, seborrheic dermatitis can have a great impact on the quality of life. Youth, female gender, and scalp lesions were significantly associated with higher DLQI scores.

Effectiveness of Interdisciplinary vs. Dermatological Care of Moderate- to-severe Psoriasis: A Pragmatic Randomised Controlled Trial

Psychiatric morbidity is frequent in patients with psoriasis. We compared the effectiveness of dermatological vs. interdisciplinary dermatological and psychiatric care for psoriasis. Adults with moderate-to-severe psoriasis were randomly allocated to dermatological (n = 24) or interdisciplinary care (n = 23) and treated accordingly. Primary endpoint was the mean change in Dermatology Life Quality Index (DLQI) at 6 months. Data was analysed by intention-to-treat. Mean ± SD change in DLQI was 7.5 ± 7.3 and 10.5 ± 9.9 after 6 months of dermatological and interdisciplinary care, respectively (p = 0.27). At baseline, 10 patients in the interdisciplinary treatment group (43%) had at least one psychiatric disorder. These patients showed significantly better DLQI response (DLQI change 14.8 ± 9.7) than patients receiving dermatological care only (p = 0.03). Ninety percent of psoriasis patients with DLQI scores exceeding psoriasis area and severity index (PASI) scores had comorbid psychiatric disease. Although psychiatric co-treatment is not generally required for patients with moderate-to-severe psoriasis, those patients with higher DLQI scores than PASI scores might benefit from interdisciplinary care.

Quality of Life in Basal Cell Carcinoma Patients in Brazil: A Pilot Cross Sectional Study

Basal cell carcinoma (BCC) is the most common malignant neoplasm in humans. BCC is asymptomatic, and its growth is slow, which may explain why patients often delay seeking treatment. To determine the clinical, historical, and demographic variables associated with the high Dermatology Life Quality Index (DLQI) scores of patients with BCC. We performed a cross-sectional study of 78 consecutive patients with primary BCCs who underwent tumor excision with margin control. Age, sex, habits, number of BCCs, BCC location, pathologic types, and DLQI were analyzed. Most patients had skin phototypes I and II (89.8%) and nodular BCC (66.0%). DLQI analysis showed that 89.7% of patients had scores less than 5 (no or small effects on patient's life). Wearing sunscreen for more than 5years, tumor ulceration, having a tumor larger than 2cm in diameter, and having a tumor located not on the head were associated with higher DLQI scores in patients (p<.05). Age, sex, outdoor activities, habitual sun exposure, or quantity of tumors did not influence quality of life. Patients who had used sunscreen for more than 5years, had ulcerated tumors, had tumors larger than 2cm and had tumors located outside of the head had higher DLQI scores.

The prevalence of melasma and its association with quality of life in adult male Latino migrant workers

Melasma is a common condition of Latino women that detracts from their quality of life (QOL). The prevalence and impact of melasma in Latino men is not well characterized. To assess the prevalence of melasma and its association with QOL in Latino men from Mexico and Central America working in the USA. The prevalence of melasma was assessed in three studies of Latino men: by direct examination in a study of 25 Latino poultry workers; by direct examination in a study of 54 Latino farm workers; and by examination of store-and-forward teledermatology images in a study of 300 Latino farm workers. QOL was assessed with a Spanish version of the Dermatology Life Quality Index (DLQI). The prevalence of melasma was 36.0%, 7.4%, and 14.0% in the three studies. The prevalence of melasma was greatest amongst those aged 31 years and older, who were from Guatemala, and who spoke an indigenous language. The presence of melasma was associated with higher DLQI scores, indicating a poorer QOL, in the poultry worker population. Melasma is a common condition in Latino men and is associated with a poor QOL in some affected individuals. Clinicians should be aware that melasma may be a concern for their male Latino patients. Research on the association of skin conditions with QOL amongst minority men is needed.

Quality of Life and Stigmatization Profile in a Cohort of Vitiligo Patients and Effect of the Use of Camouflage

Background: Few studies have paid attention to the effects of treatment interventions on the psychosocial consequences of vitiligo. Objectives: To quantify and analyse the psychosocial benefit of the use of camouflage in vitiligo patients. Patients and Methods: 78 vitiligo patients completed the Dermatology Life Quality Index (DLQI) and an adapted stigmatization questionnaire, and 62 of them completed the DLQI after at least a 1-month use of camouflage. Results: The initial mean overall DLQI score (n = 78) is 6.9 (SD 5.6). The mean global stigmatization score is 38%. Disease extent and disease severity are strong predictors of the DLQI (p < 0.0001). Vitiligo on the face/head/neck substantially affects the DLQI, independently of degree of involvement. The mean DLQI score before and after use of camouflage (n = 62) is 7.3 (SD 5.6) and 5.9 (SD 5.2; p = 0.006). Mainly the high-scoring items ‘feelings of embarrassment and self consciousness’ and ‘choice of clothing’ improve. Predictors of improvement are higher DLQI scores (p = 0.0005) and higher total severity scores (p = 0.03). Conclusions: Camouflage can be recommended, particularly in patients with higher DLQI scores or self-assessed disease severity. Patients with minor involvement of the face benefit from camouflage.