Mean Dermatology Life Quality Index Score Research Articles

Baricitinib for Prurigo Nodularis: A Pilot Study on Efficacy and Safety

Background. Breaking the itch-scratch cycle and facilitating lesion healing are pivotal in managing prurigo nodularis (PN). This study seeks to assess the efficacy of baricitinib, an oral JAK1/2 inhibitor, for treating PN. Methods. In this prospective pilot study, 12 patients with moderate to severe PN were administered oral baricitinib at a dosage of 4 mg/day for 12 weeks. The primary objective was to assess the efficacy of baricitinib in PN patients using the numeric rating scale (NRS) for pruritus, NRS sleep score, a 5-point investigator’s global assessment (IGA) scale, dermatology life quality index (DLQI), and nodular lesion count at weeks 0, 1, 2, 4, 8 and 12. In addition, the NRS pruritus and sleep scores were assessed via phone on days 2 and 4 after baricitinib treatment. Results. Baricitinib treatment led to a statistically significant improvement in the mean NRS pruritus and sleep scores, evident as early as day 2 (57.7% change from baseline; P<0.001, and 34.7% change from baseline, P=0.029, respectively) and consistently declining thereafter. Evaluation of nodular lesions revealed a significant reduction starting from week 2 (mean difference of 37.08 from baseline; P<0.001). Analysis of other endpoints, including mean DLQI and IGA scores, also demonstrated substantial improvement at all time points (week 1, 2, 4, 8, and 12) compared to baseline. However, it is important to acknowledge the limitation of a small sample size. This constraint warrants consideration when interpreting the results and generalizing the findings. Conclusion. This preliminary study underscores baricitinib’s potential for PN treatment by providing a rapid clinical response. The larger and longer randomized controlled trials are essential to determine the effectiveness, longevity, and safety of baricitinib in managing PN. This trial is registered with TCTR20230227002.

Demographic and Clinical Features and Factors Affecting the Quality of Life of Patients With Hidradenitis Suppurativa: A Cross-sectional Study.

Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with well-known adverse effects on quality of life (QoL). Improving patients' QoL has become an important objective of treatment. The purpose of this study was to evaluate the demographic and clinical characteristics and factors affecting the QoL of patients with HS. One hundred seventy-six patients with HS aged between 18 and 65 years were included in the study. The patients' demographic and clinical characteristics, treatments, and comorbidities were recorded. The disease stage was determined based on the Hurley staging system. The Dermatology Life Quality Index (DLQI) was used to evaluate QoL. Mean DLQI scores were significantly higher in patients with advanced Hurley stages, lesions in the gluteal region and legs, and with more than 2 affected areas (p < .001). Correlations between patient-reported treatment outcomes and clinical characteristics of the patients were assessed. Findings of this study indicate the existence of a potential "window of opportunity" for laser epilation and wide local surgical excision, similar to anti-tumor necrosis factor therapy. Timely and appropriate treatment can only be provided for patients with HS by evaluating objective disease severity measures and subjective patient data in combination.

Real-world data on the effectiveness of brodalumab in patients with moderate-to severe plaque psoriasis in the Greek clinical setting (the BrIDGE study).

Despite that brodalumab's efficacy and safety have been assessed in randomized clinical trials, real-life data remain scarce. BrIDGE was an observational, prospective, single-cohort, multicentre study that recruited patients with moderate-to severe plaque psoriasis in Greece. The primary objective was to assess the proportion of patients who achieved Psoriasis Area and Severity Index (PASI)100 after 24 weeks. Other endpoints included: the maintenance of PASI90/100 through to 104 weeks, the short-term response [PASI75/90/100 and static Physician's Global Assessment (sPGA) 0/1] to brodalumab at 12-16 weeks and time to complete clearance. Moreover, we explored the change in quality of life [Dermatology Life Quality Index (DLQI) 0/1] and adherence to brodalumab. Two hundred patients who were initiating treatment with or switching to brodalumab, were recruited. Analyses were conducted using the as observed data and three imputation approaches were also applied for the missing data (last observation carried forward, 'worst case' and 'best case' scenario). Continuous variables were reported using summary statistics, whereas categorical variables were reported in frequency tables. Based on the 'as observed data', 42.0% of patients achieved PASI100 at Week 24 after 25.9 ± 3.5 weeks and 65% of patients attained PASI100 at Week 104. In total, 70.2%, 47.5% and 32.0% achieved PASI75/90/100, respectively, whereas 72.6% of patients achieved sPGA 0/1, at Weeks 12-16. With respect to sPGA status 82.8%, 89.2% and 92.5% of patients achieved sPGA 0/1 at Weeks 24, 52 and 104, respectively. The time to achieve PASI100 at Weeks 12-16 was 13.7 ± 1.3, 52.1 ± 3.4 weeks at Week 52 and 105.5 ± 4.8 weeks at Week 104. Mean DLQI and Psoriasis Symptom Inventory (PSI) scores decreased by 11.4 ± 7.0 and 15.4 ± 6.5 points from baseline to Week 104, respectively. Adherence to treatment was equal to 98.9%. Brodalumab confers rapid and durable responses, as well as improvements in the quality of life of moderate-to-severe psoriasis patients.

Efficacy of Botulinum Toxin in the Treatment of Cutaneous Flushing: A Systematic Review and Meta-Analysis.

Flushing is a common dermatologic complaint and can be resistant to many treatments. As the utility of botulinum toxin continues to expand, recent data suggest that it may also be a therapeutic option for flushing. To evaluate the efficacy of botulinum toxin for the treatment of cutaneous flushing. A systematic search of Medline, Embase, Cochrane CENTRAL, CINAHL, Scopus, and Web of Science databases was conducted to identify studies evaluating the effect of botulinum toxin on flushing 1 month after treatment. Prespecified outcome measures included a clinical flushing score, dermatology life quality index (DLQI), and erythema index (EI). Meta-analysis was performed to calculate the mean differences in these outcomes before and after treatment at 1-month follow-up. Nine studies (132 patients) were included in the analysis of this study (2 randomized controlled trials and 7 nonrandomized studies). All studies had a low risk of bias (high quality). The most frequent outcome reported was a clinical flushing score, which significantly decreased by 1.25 points overall (95% confidence interval [CI]: -2.47; -0.04) 1 month after treatment with botulinum toxin. Mean DLQI scores decreased (i.e., improved) by 9.02 points (95% CI: -19.81; 1.77) 1 month after botulinum toxin injections. The EI (measured by Mexameter) before and after botulinum toxin was evaluated in 2 studies; however, not enough statistical information was provided to analyze with meta-analytic techniques. Based on this meta-analysis, botulinum toxin significantly improves clinical flushing scores 1 month after treatment.

Management Outcomes of Hand Dermatitis in a Tertiary Hospital in Southwest Nigeria.

Hand dermatitis (HD) is inflammation of the skin of the hands. It ranges in severity and has a significant impact on quality of life (QoL). The physical and psychosocial burden of the disease is comparable with psoriasis in impairment of the QoL of the patient and depression. Quality of life correlates with disease severity. To evaluate the management outcome of HD with a disease severity tool by the physician and quality of life index. This was a cross-sectional study of a cohort of patients with HD over 24 weeks in the dermatology clinic of a tertiary hospital in Nigeria. Disease severity and quality of life were measured using the physician global assessment (PGA) and dermatology life quality index (DLQI), respectively. These were re-administered 6 weeks after treatment. Results were collated and analyzed. One hundred and seventy-seven (13.3%) of 1,329 patients had HD with F/M ratio of 1.2: 1; a mean age of 34.6 ± 7.4 years. Comparing PGA scores at baseline and 6 weeks, a statistically significant improvement was noted P < 0.001. The mean DLQI score at baseline was 10.38 and reduced to 3.02 post-treatment. The difference between the two means of the DLQI was ≥5 from baseline signifying improved quality of life. The domain of symptoms and feelings was the most affected at baseline and most improved afterward. HD has a significant impact on its sufferers and this correlates with disease severity. Appropriate management improves disease outcome and patients' quality of life.

Burden of vitiligo on Chinese patients: an online survey.

Burden of vitiligo on Chinese patients: an online survey.

Dermatological concerns for women and girls with turner syndrome.

Turner syndrome (TS) is associated with distinct manifestations in women and girls including short stature, cardiac abnormalities, premature ovarian failure as well as dermatological features, including lymphedema, keloids, onychodystrophy, and acne. Although many dermatological concerns present during the first few decades of life, the overwhelming majority of respondents are not provided with dermatology referrals at diagnosis. This cross-sectional study utilized an author designed survey to assess self-reported dermatological manifestations, dermatology referral experience, common therapies for select dermatological conditions, as well as a validated 10-question Dermatology Life Quality Index (DLQI) to assess quality-of-life impact in women and girls with Turner syndrome. In our cohort, 64% (n = 149) had been referred to a dermatologist at some point in their life time. The majority of individuals self-identified their dermatological concern (79.6%) and were referred after a dermatological concern had already occurred (90.2%). The most common dermatological findings reported were xerosis cutis (78.7%), lymphedema (73%), and more than 20 acquired melanocytic nevi (70%). The overall mean DLQI score was 3.52, indicative of a small effect on the patient's life. Onychodystrophy, history of skin biopsy, and lymphedema were statistically significant to have a higher impact on quality of life. Our data reveal that skin conditions are highly prevalent in the TS population during the early decades of life and affirm utilizing these conditions in the TS diagnostic process, as well as emphasize the need for specialized dermatology referrals to address the detrimental impacts related to skin concerns on quality of life.

Resorcinol 10% as a Promising Therapeutic Option for Mild Hidradenitis Suppurativa: A Prospective, Randomized, Open Study

Introduction: Treatment of hidradenitis suppurativa (HS) is challenging, and in Hurley stage I, it is based on topical measures. Our aim was to compare the efficacy and safety of topical resorcinol 10% with topical clindamycin 1% and no therapy, in Hurley stage I HS. Methods: In this open, prospective, randomized trial, we studied 60 Hurley stage I patients with IHS4 ≤10. Group A was treated with topical resorcinol 10%; group B with clindamycin lotion 1%; and group C received no treatment. Patients were evaluated by total lesion count, the International Hidradenitis Suppurativa Severity Score System (IHS4) and the Dermatology Life Quality Index (DLQI) at baseline, 12 and 24 weeks. Self-reported number of flares and adverse events (AEs) were recorded. Results: A significant reduction in the mean total lesion count and DLQI scores were observed in group A, compared to group B at week 12 (p = 0.036, p < 0.001, respectively), and in the mean total lesion count, IHS4, and DLQI scores at week 24 (p = 0.034, p = 0.017, p < 0.001, respectively). Resorcinol 10% was well-tolerated with only mild AEs. Conclusion: Resorcinol 10% may represent a useful alternative for the long-term treatment of mild HS, which is superior to topical clindamycin and has a favorable safety profile.

Abrocitinib effect on patient-reported outcomes in patients with moderate-to-severe atopic dermatitis: Results from phase 3 studies, including the long-term extension JADE EXTEND study.

Abrocitinib improved signs and symptoms of moderate-to-severe atopic dermatitis (AD) at Weeks 12 and 16 in phase 3 studies, with a manageable safety profile. Patient-reported outcomes with long-term abrocitinib treatment were not reported. To evaluate patient-reported outcomes with long-term abrocitinib treatment in patients with moderate-to-severe AD. JADE EXTEND (NCT03422822) is an ongoing, phase 3, long-term extension study that enrolled patients from previous abrocitinib AD trials. This analysis includes patients from the phase 3 trials JADE MONO-1 (NCT03349060), JADE MONO-2 (NCT03575871) and JADE COMPARE (NCT03720470) who completed the full treatment period of placebo or abrocitinib (200 or 100 mg once daily) and subsequently entered JADE EXTEND and were randomised to receive once-daily abrocitinib 200 or 100 mg. Patient-reported endpoints to Week 48 included the proportion of patients who achieved Dermatology Life Quality Index (DLQI) scores of 0/1 (no effect of AD on quality of life [QoL]) and a ≥4-point improvement in Patient-Oriented Eczema Measure (POEM) score (clinically meaningful improvement). Data cut-off: April 22, 2020. Baseline DLQI mean scores were 15.4 and 15.3 in the abrocitinib 200- and 100-mg groups, respectively, which corresponded to a 'very large effect' on QoL; at Week 48, mean DLQI scores were lower with abrocitinib 200 mg (4.6; 'small effect' on QoL) and abrocitinib 100 mg (5.9; 'moderate effect' on QoL). Baseline POEM mean scores were 20.4 and 20.5 in the abrocitinib 200- and 100-mg groups, respectively; at Week 48, mean POEM scores were 8.2 and 11.0. Week 48 patient-reported responses with abrocitinib 200 mg and abrocitinib 100 mg were 44% and 34% for DLQI 0/1, and 90% and 77% for a ≥4-point reduction in POEM score. In patients with moderate-to-severe AD, long-term abrocitinib treatment resulted in clinically meaningful improvement in patient-reported symptoms of AD, including QoL.

P98 Real-world effectiveness of guselkumab in absolute Psoriasis Area and Severity Index-stratified patients with psoriasis: data from the British Association of Dermatologists Biologics and Immunomodulators Register

Abstract Guselkumab is a fully human monoclonal antibody that inhibits interleukin-23 by selectively targeting the p19 subunit. Long-term evaluations have demonstrated high levels of clinical response and improvement in patient-reported outcomes over 5 years of guselkumab treatment in patients with psoriasis. Psoriasis has a significant and negative impact on a patient’s quality of life, even among patients with a Psoriasis Area and Severity Index (PASI) score &amp;lt; 10. Both absolute PASI (aPASI) and the Dermatology Life Quality Index (DLQI) are widely used tools to assess disease impact, as well as treatment eligibility and response. This retrospective analysis evaluated the impact of guselkumab treatment over 1 year across aPASI-stratified patients with psoriasis in BADBIR, a national pharmacovigilance registry documenting longitudinal clinical data for individuals with psoriasis initiating systemic therapies. Retrospective analyses of the guselkumab cohort were carried out using BADBIR data collected up to September 2021. Data were analysed for patients who had initiated guselkumab treatment and had recorded aPASI and DLQI assessments at both baseline and the 12-month follow-up. Patients were stratified according to psoriasis severity at baseline: aPASI &amp;lt; 5, aPASI ≥ 5 to ≤ 10 and aPASI &amp;gt; 10 disease. Treatment effect was defined as the mean improvement in DLQI and aPASI scores for the overall group of guselkumab-treated patients and for subsets of patients with aPASI &amp;lt; 5, aPASI ≥ 5 to ≤ 10 and aPASI &amp;gt; 10 at baseline. Five patients were excluded owing to treatment cessation prior to the 12-month cutoff. Following 12 months of guselkumab treatment, patients with aPASI &amp;lt; 5, aPASI ≥ 5 to ≤ 10 and aPASI &amp;gt; 10 at baseline achieved a mean (SD) DLQI score of 2.18 (5.64), 2.79 (5.15) and 1.80 (3.56), representing a decrease of 62.0%, 74.8% and 89.1% from baseline, respectively. Additionally, patients with aPASI &amp;lt; 5, aPASI ≥ 5 to ≤ 10 and aPASI &amp;gt; 10 at baseline achieved a mean (SD) aPASI score of 0.96 (1.84), 3.16 (3.90) and 2.78 (4.93), representing a decrease of 40%, 58.6% and 84.5% from baseline, respectively. Among patients with an aPASI score &amp;lt; 10 at baseline (n = 53), 83.0% (n = 44) achieved aPASI score ≤ 3; of these, 67.9% (n = 36) achieved an aPASI score ≤ 2 and 54.7% (n = 29) achieved an aPASI score ≤ 1. These data demonstrate that guselkumab produces an effective and consistent response in patients with a broad range of disease severity at baseline, as reflected by mean improvements in aPASI and DLQI. Greater reductions in DLQI and aPASI scores were observed after 12 months of guselkumab treatment in patients with more severe psoriasis at baseline.

Effect of Electro Optical Synergy System (ELOS) on Improving Quality of Life in Hirsutism

Hirsutism is a very common problem. Different treatment options are available to treat this condition. ELOS is one of the fast growing treatment modality leading to improvement in quality of life of hirsute women. Objective: To assess mean decrease in dermatology life quality index (DLQI) in hirsuate women treated with electro optical synergy system (ELOS). Methods: This study was conducted involving 100 women aged between 16-60 years presenting with hirsutism having DLQI score of &gt;10 at presentation. These women underwent treatment with electro optical synergy system (ELOS); 3 sessions 4 weeks apart. DLQI score was assessed again 4 weeks after 3rd session. Results: The mean age of women in this study was 24.8±7.9 years. Majority (n=73, 73.0%) of these women was unmarried. The mean duration of disease was 5.2±2.2 years. The mean DLQI score was 18.46±4.72 at baseline which decreased to 11.96±5.28 after treatment with ELOS. The mean decrease in DLQI score was 6.50±1.81. Conclusions: In the present study it was seen that in women presenting with hirsutism, electro-optical synergy system (ELOS) treatment resulted in improved quality of life evident from a statistically significant decrease in DLQI score.

Quality of life and patient-reported symptoms in a Phase 4, real-world study of tildrakizumab in patients with moderate-to-severe psoriasis: Week 28 interim analysis

BackgroundTildrakizumab is an anti–interleukin-23 p19 monoclonal antibody approved for the treatment of adults with moderate-to-severe plaque psoriasis. Little real-world evidence is available regarding the effects of tildrakizumab on patients’ health-related quality of life (HRQoL) and patient-reported symptoms.ObjectiveThis real-world study of tildrakizumab evaluated changes in HRQoL and clinical symptoms in patients with psoriasis.Materials and methodsIn this Week (W)28 interim analysis of a 64-week Phase 4 study (NCT03718299), patients received tildrakizumab 100 mg at W0, W4, and every 12 weeks thereafter. Endpoints were improvement from baseline in Psychological General Well-Being Index (PGWBI), Dermatology Life Quality Index (DLQI), and Itch-, Pain-, and Scaling-Numerical Rating Scale scores through W28.ResultsOf 55 patients enrolled, 53 were assessed at W28. Mean (standard deviation [SD]) total PGWBI score improved from baseline to W28 (change, 3.7 [12.4]; p = .033), as did the positive well-being (1.0 [2.9]; p = .018) and general health (1.5 [2.2]; p < .001) domain scores. Mean (SD) DLQI score improved by −3.9 (4.3) at W4 and by −7.6 (5.1) at W28 (p < .001). Patient-reported symptoms improved starting at W4 (p < .001).ConclusionTildrakizumab treatment improved HRQoL and patient-reported symptoms in patients with psoriasis in a real-world setting. Clinical trial registration: https://clinicaltrials.gov/ct2/show/NCT03718299

Employing Adalimumab in Treatment of Moderate-to-Severe Hidradenitis Suppurativa: Real-Life Multicenter Data from the Czech Republic

Adalimumab is the only approved biologic treatment for moderate-to-severe hidradenitis suppurativa, nonetheless, long-term data from real-life setting are still limited. The objective of this observational multicenter study was to evaluate the effectiveness, safety, and drug survival of adalimumab in patients with hidradenitis suppurativa included in the BIOREP registry. A total of 299 patients who initiated adalimumab therapy for hidradenitis suppurativa from 2011 to November 2021 were included. The Dermatology-Life-Quality-Index (DLQI), pain scale, the number of abscesses, inflammatory nodules and draining tunnels, and International Hidradenitis Suppurativa Severity Score System (IHS4) were recorded in the 0th, 3rd, and 6th months; then every 6 months during the ongoing adalimumab treatment. Studied patients underwent treatment for up to 48 months, with the average duration of treatment lasting 2.3 years. The mean age of the patients was 44.9 years, 79% were smokers or ex-smokers, 54.8% were obese, and 26.4% were overweight, the mean BMI was 30.8. The mean time from diagnosis to initiation adalimumab therapy was 9.1 years. The number of patients with severe IHS4 dropped from the initial 249 (83.3%) to 65 (30.1%) after 12 months and this trend was maintained up to the 48th month. A decreasing number of inflammatory lesions were rapid and sustained and correlated to the improvement of patients’ quality of life, the mean DLQI score dropped from 17.6 to 8.5 after 3 months and to 5, 7 after 48 months. No unexpected risk signals were observed. Our long-term study demonstrates the effectiveness and safety of adalimumab in a real-life setting.

The dermatology life quality index among healthcare workers during the COVID-19 pandemic

IntroductionDuring the COVID-19 pandemic, there has been a peak of occupational dermatoses associated with Personal Protective Equipment (PPE) among healthcare workers (HCWs). The resulting dermatological damage might have an impact on the quality of life.ObjectivesWe aimed to evaluate the dermatological life quality of the HCWs due to PPE use.MethodsThe study was conducted in a group of HCWs from Hedi Chaker hospital in Sfax, Tunisia. Data were gathered between march and may 2021 using a self-administered questionnaire including socio-professional characteristics, evaluation of skin lesions, evaluation of the infection-prevention practices and the Arabic version of the Dermatology Life Quality Index (DLQI).ResultsOur sample was composed of 190 HCWs. The respondents’ mean age was 32.5 ± 6.5 years and 54.7% were female. The average job tenure was 6.6 ± 5.8 years. Doctors represented 22.1 %, nurses 13.6% and cleaning staff 64.3 % of participants. The prevalence of skin lesions due to PPE among HCWs was 51.6%. The mean time of mask use was 15.4 ± 9.1 hours. The daily hand washing frequency was &gt;10 times/day in 85.3 % of participants. The mean DLQI score was 3.3 ± 4.3. According to this index, it was found that these skin lesions had no effect, small effects, moderate effects and very large effects on the lives of 43.9%, 34.7%, 12.2%, and 9.2% of participants, respectively. The DLQI was correlated with hand washing frequency (p = 0.014, r = 0.204) and the time of mask use ( p = 0.038, r = 0.172).ConclusionsSkin lesions among HCWs are frequent during the covid-19 pandemic. These lesions influence the quality of life of the HCWs. This risk gets higher with excessive preventive measures. It is critical to provide training on the prevention of skin lesions associated with PPE wearing and hand hygiene before and during the period of use of preventive measures.Disclosure of InterestNone Declared

The impact of hand eczema severity on quality of life in workers engaged in lock making: A cross-sectional study from tertiary care hospital

Objectives: Hand eczema is a frequent condition that dermatologists commonly encounter. It leads to considerable impact on quality of life (QOL) by significant functional impairment, disruption of work, and discomfort in the working population. The symptoms range from a minor discomfort to a serious debilitating and long-term conditions. Workers engaged in lock making constitute an economically poor section of society. They are exposed to different kinds of allergens, hence are predisposed to develop hand eczema. The aim of this study was to study the impact of hand eczema on the QOL in workers engaged in lock making. Materials and Methods: A total of 65 workers engaged in lock making and suffering from hand eczema, who visited the out-patient department of dermatology for 6 months, were included in this study. Data on QOL were obtained through a questionnaire devised by Finlay et al. Hand eczema severity index (HECSI) was used to assess the severity of disease. Associations were drawn regarding Dermatology Life Quality Index (DLQI) and HECSI scores with age, sex, duration of disease, number of episodes of illness, and number of sick leaves. Results: Sixty-five patients suffering from hand eczema and engaged in lock making participated in this study, of which 52 (80%) were male and 13 (20%) were female. The commonest age group affected was 36–40 years (41.53%). The most common morphological pattern seen was hyperkeratotic palmar eczema in 50.7% (n = 33) patients followed by chronic dry fissured eczema in 35.3% (n = 23). The mean HECSI score was 19.52 (Standard deviation [SD] = 9.416) and mean DLQI score was 9.92 (SD = 2.426). A significant association of DLQI was seen with duration of disease (P = 0.011), number of episodes of eczema (P = 0.003), and number of sick leaves taken (P = 0.005). Similarly, HECSI score showed significant association with duration of disease (P = 0.002) but not with number of episodes of eczema (P = 0.056). No significant association was found between hand eczema severity and QOL. Being a OPD-based study, it may not truly reflect the community data. Patch test could not be done as workers were poor and could not afford it. Conclusion: Lock makers with hand eczema showed considerable impairment of their QOL. Further, they are more prone to absenteeism from work.

QUALITY OF LIFE USING DERMATOLOGY LIFE QUALITY INDEX IN FEMALE PATIENTS WITH HIRSUTISM

Hirsutism affects a woman's social and quality of life in our society. The burden and magnitude of this effect vary from population to population. A local study was designed to determine the burden on our population. The Objective of this Cross-Sectional study was to determine the frequency of very large and extremely large effects on quality of life using Dermatology Life Quality Index (DLQI) in hirsute women presenting to Jinnah Hospital,Lahore. This study was conducted at the Outpatient Department of dermatology Jinnah hospital Lahore from 13th May 2014 to 12th November 2014. Females with hirsutism and age ranging from 18 to 49 years were included in the study. Hirsutism was labeled if the woman had Ferriman-Gallway (F-G) score ≥ 8 or one area score equal to 4, determined by clinical examination. Quality of life was determined using Dermatology Life Quality Index and waslabeled as having a very large and extremely large effect if DLQI scores were 11-20 and 21-30, respectively. The marital and educational status will be used to stratify data and dig out effect modification. Two hundred twenty patients included in our study had a mean age of 26.38± 5.58 years ranging from 12 to 42 years. The mean Ferriman-Gallway score was 15.45± 3.5, while the mean DLQI score was 18± 5.09. Diagnosis of included women was Hyperprolactinemia (4/220, 1.8%), Congenital Adrenal Hyperplasia (5/220, 2.3%), Ovarian Tumors (8/220, 3.6%), Polycystic Ovarian Disease (135/220, 61.4%) and others (68/220, 30.9%). 97% of the included patients had some formal education. 124 (56.4%) were Unmarried, 94 (42.7%) were married, while 2 (0.9%) were divorced. On DLQI, an Extremely Large Effect was present in 85 (38.6%), a Very Large effect in 115 (52.3%) while Small Effect was observed in 20 patients. There is no effect of cause or diagnosis, marital status, or educational status of thesampled population. It is concluded that the frequency of Extremely Large Effect and Very Large effect wasobserved in more than half of the study population with hirsutism. The high burden of Extremely Large Effect on quality of life necessitates emotional and psychological rehabilitation as well as pharmacological and cosmetic methods in treating these patients.

Evaluation of Dermatology Life Quality Index, Depression-Anxiety-Stress Scores of Patients with Genital Dermatoses.

Genital dermatoses contain a group of diseases that affect the skin of the genital area. Genital dermatoses are classified as venereal and nonvenereal. They can affect a patient's life quality and can cause depression, anxiety and stress. This study aimed to evaluate and compare the quality of life index, depression, stress and anxiety in patients with genital dermatoses. Patients admitted to the dermatology outpatient clinic with genital skin complaints between October 2020 and March 2021 were included. A questionnaire including demographic information, a 10-item dermatology life quality index (DLQI) and a 21-item depression anxiety stress score (DASS-21) was filled out by the patients and was calculated. A total of 103 patients were included in this study. Seventy-seven (74.8%) were male and 26 (25.2%) were female. A total of 48.5% (n = 50) patients had venereal genital dermatoses, and 51.5% (n = 53) of the patients had nonvenereal genital dermatoses. In the venereal diseases, syphilis had the highest DLQI, depression, anxiety and stress score while in the nonvenereal diseases, scabies had the highest DLQI, depression, anxiety and stress score. In the nonvenereal group, the mean DLQI score, depression, anxiety and stress scores were statistically significantly higher than the venereal genital dermatoses group (P < 0.01, P = 0.04, P = 0.03 and P = 0.02). The quality of life of patients with genital dermatoses is often poor, with significant levels of depression, anxiety and stress. We believe that screening these patients with DLQI and DASS-21 scores at their first admission and follow-up will benefit dermatologists and patients.

Long-Term Efficacy, Safety, and Drug Survival of Guselkumab in Patients with Psoriasis: Real-World Data from the Czech Republic BIOREP Registry.

Real-world data on the long-term use of guselkumab for treatment of psoriasis are still limited. We aimed to evaluate long-term efficacy, safety, and drug survival of guselkumab in a real-world setting. This is a retrospective study analyzing Czech Republic registry (BIOREP) data of patients treated with guselkumab. In total, 333 patients were included. Improvement in Psoriasis Area and Severity Index (PASI) score was significant. Mean PASI score decreased from 16 at baseline to 0.7, 0.9, and 0.8 after 12, 24, and 36months, respectively. Absolute PASI scores of ≤ 3 and ≤ 1 were achieved in 93.9% and 77.9%, 94.2% and 71.0%, and 94.8% and 70.7% of patients after 12, 24, and 36months, respectively. Response PASI 90 and PASI 100 were attained in 81.8% and 57.1%, 75.4% and 50.7%, and 75.9% and 55.2% of patients after 12, 24, and 36months, respectively. The percentage of patients achieving PASI 90 and PASI 100 responses was higher throughout the study in bio-naive and in normal-weight patients, while presence of psoriatic arthritis had no influence. Improvement in Dermatology Life Quality Index (DLQI) score was also significant; mean DLQI score decreased from 14.2 at baseline to 0.9, 1.0, and 0.7 after 12, 24, and 36months, respectively. Patients with PASI 100 had lower mean DLQI throughout the study compared with patients with PASI 90. Major reason for discontinuation was loss of effectiveness in 7.1% of patients, while only 0.6% were due to adverse events. Overall cumulative drug survival was high, with only a minimal decline over time, reaching 91.6%, 87.0%, and 85.5% after 12, 24, and 36months, respectively. Drug survival was not affected by previous biological treatment, patient weight, or presence of psoriatic arthritis. This real-world study demonstrated the long-term effectiveness, good safety profile, and high drug survival of guselkumab treatment over a period of 36months.

Development of the lichen planus quality of life questionnaire (LPQoL) informed by expert clinician input and patient feedback: a retrospective survey study.

Lichen planus (LP) can affect multiple body sites including skin, mucosae, scalp and nails, causing considerable impact on patients' quality of life. Currently, there are no LP patient-reported outcome measures (PROMs) that address all body sites potentially affected by LP. We developed a LP Quality of Life Questionnaire (LPQoL), informed by an expert consortium and patient survey study, to address this gap. The study was approved by our institution's Institutional Review Board. First, a 22-item LPQoL was designed with input from LP experts at our institution. The tool was then optimized by garnering input from patients recently diagnosed with LP, who were asked to complete the LPQoL, as well as the Dermatology Life Quality Index (DLQI) and a feedback form about the LPQoL. Fifty-eight of 150 patients (39% response rate) returned the questionnaire. Mean DLQI score was 4.9 ± 5.6 SD (range 0-25) and mean LPQoL score was 13.6 ± 10.4 SD (range 0-54). LPQoL score was positively correlated with DLQI score (r = 0.79; p < 0.001). Forty-nine out of 56 (88%) and 6/56 (11%) rated the LPQoL as 'very easy' or 'fairly easy' to complete, respectively. Based on participants' feedback, we increased the recall period from one week to one month and added questions on esophageal involvement. With iterative input from LP experts and patients, we developed a LPQoL to address the gap in a multi-site PROM specific to LP. This is a pilot study and there is ongoing validation studies; therefore, this measure should not be used in clinical practice or research until validated.

Characteristics associated with quality of life in the early stages of Mycosis Fungoides.

Mycosis fungoides (MF) is a lymphoproliferative disorder characterized by skin-homing atypical lymphocytes. This study aimed to evaluate the quality of life (QoL) in MF patients in the early stages of the disease and the associated factors using the Dermatology Life Quality Index (DLQI). Thirty MF patients (21 females/9 males) with a mean age of 46.73±15.9 years and in the early stages of the disease (26 stage Ι and 4 stage ΙΙ) were enrolled and were asked to fill the DLQI questionnaire. The mean DLQI score was 9.93±5.89. The QoL was largely affected by the disease in near half of the patients (46.7% of patients had a DLQI score11-20). QoL was significantly correlated with educational level and was more impaired in patients with lower educational status (DLQI score spearman rho=-0.382, P=0.037). QoL was not associated with sex, age, disease stage and disease duration. The symptom and feeling dimension of DLQI was significantly more impaired in patients with both patch and plaque compared to patch only (spearman rho= 0.397, P= 0.03). This study demonstrates how largely patients' QoL is influenced in the early stages of MF, especially in patients with lower educational levels.