Mean Dermatology Life Quality Index Research Articles

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.

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.

Correlation of quality of life and severity in patients with melasma

Background: Melasma is a disorder of acquired facial hyperpigmentation, typically affecting young females. It is known to cause a great psychological impact and a significant negative effect on a patient’s quality of life. Objectives: To explore the correlation between the quality of life in melasma patients and the severity of melasma. Methods: This hospital-based, analytical, cross-sectional study was conducted from 2020 October to 2021 December in the Department of Dermatology, Venereology and Leprology of Kathmandu Medical College after institutional ethical clearance, in 101 patients recruited by convenience sampling. The quality of life was calculated using the Nepali version of the Dermatology Life Quality Index (DLQI) questionnaire and severity of melasma was calculated using modified Melasma Area and Severity Index (mMASI). Data analysis was done by SPSS v.24. Results: The study included 101 patients of melasma with a young female preponderance. Seventy-eight (75.7%) being female and 43 (42.6%) being between the age of 21-30 years. The mean DLQI score was 10.39 ± 3.22; interpreted as having a ‘very large effect on a patient’s life.’ While the mean mMASI score was calculated to be 5.53 ± 2.69; interpreted as a melasma severity score (MSS) of ‘moderate severity.’ A significant positive moderate correlation r = 0.431 (p <0.001) was observed between mMASI and DLQI. Conclusion: Melasma is a common pigmentary disorder that has a very large effect on the patient’s quality of life and this correlates directly with the severity of melasma.

The Use of IL-17 and IL-23 Inhibitors in Swedish Clinical Practice: A Register-Based Analysis

Background: Interleukin (IL) inhibitors have made completely cleared skin achievable for many patients with moderate to severe psoriasis in clinical trial settings. Few observational studies assess treatment response in accordance with treatment goals in guidelines. Objectives: The aim of the study was to analyze the treatment response of IL-17/IL-23 inhibitors in clinical practice and the proportions of patients that reach the treatment target of the Psoriasis Area and Severity Index (PASI) < 3 and the Dermatology Life Quality Index (DLQI) ≤5. Methods: A longitudinal, observational study based on the Swedish National Registry for Systemic Treatment of Psoriasis, PsoReg. Patients using IL-17/IL-23 inhibitors with assessments of PASI, DLQI, and EQ-5D before (maximum 6 months) and after (3–12 months) initiation of IL-17/IL-23 were included. Results: In total, 333 patients using IL-17/IL-23 inhibitors were included. Eighty percent (n = 266) received IL-17 inhibitors, and 20% (n = 67) received IL-23 inhibitors. Sixty-six percent of patients reached both PASI <3 and DLQI ≤5, 23% reached one target, and 11% reached none. The mean (SD) PASI, DLQI, and EQ-5D improvements were 6.75 (6.99), 7.14 (7.97), and 0.126 (0.296), respectively. There was no statistically significant difference in outcomes between IL-17 and IL-23 inhibitor treatment groups. Conclusions: IL-17/IL-23 inhibitors are effective in clinical practice, but there is still an unmet therapeutic need in moderate to severe psoriasis.

A Cross-Sectional Study on the Relationship Between Rosacea Severity and Quality of Life or Psychological State.

Rosacea appears predominantly in highly visible areas of the facial region. To investigate the psychological status and quality of life(QOL) of rosacea. We used a hospital-based cross-sectional analytical study design between Jan 1, 2020, and Jan 1, 2021. We analyzed the differences and correlations in the severity of rosacea and its impacts on QOL and mental health, separately. 469 patients with rosacea were included. The mean Dermatology Life Quality Index (DLQI) score was 12.6±7.7 and the affected level of DLQI was moderately severe. The total score of Rosacea-specific Quality-of-Life instrument (RosQol) was 2.34 ± 0.84, and the scores of emotion, symptoms, and function were 2.41 ± 0.99, 2.37 ±0.82, and 2.03 ± 0.89, respectively. 44.8% of patients suffered from anxiety and 37.5% from depression. There were statistically significant differences in the incidence of anxiety (p <0.001), the DLQL (p =0.02), RosQol emotion (p =0.04), symptom (p <0.01) and function (p =0.02) scores in the different severity. In addition, worsening QOL was significantly associated with increased disease severity [Spearman's rank correlation index (r) ranging from 0.171 to 0.266,p<0.01 (RosQol); r =0.104,p =0.024 (DLQI)]. There was also a positive correlation between anxiety [r =0.155; p<0.01] and the different severity levels. Rosacea maybe has a greater significant impact on patient's QOL and mental health. And the impact of QOL and mental health tend to deteriorate significantly with increasing disease severity. The relationship suggests that QOL assessment is of great interest in clinical practice and should be further explored.

Real-world treatment patterns, patient-reported outcomes, and effectiveness of flexibledosing etanercept in patients with plaque psoriasis in Greece.

Etanercept is approved for continuous or intermittent use and flexible dosing in plaque psoriasis (PsO). The objectives of this study were to investigate real-world treatment patterns with etanercept in Greek adults with moderate-to-severe PsO. This non-interventional multicenter study included a retrospective-to-prospective (RP) cohort, previously treated with etanercept for ≥24 months and followed for an additional 6 months, and a biologic-naïve, prospective-only (PO) cohort, followed for 6 months after treatment initiation. Parameters assessed included Psoriasis Area and Severity Index (PASI), percentage of body surface area (BSA) affected, Dermatology Life Quality Index (DLQI), and adverse events (AEs). This study enrolled 123 patients (RP, n = 56; PO, n = 67), who mostly adhered to continuous treatment (RP, 68%; PO, 95%). The two cohorts had similar mean baseline-to-endpoint decreases in PASI (-9.5 vs -10.1) and BSA (-11.9 vs -12.3). The PO-CTP population had a mean DLQI baseline-to-endpoint score decrease of -5.8, which was statistically significant and clinically meaningful. Treatment-emergent AE rates were 58.9% (RP) versus 26.9% (PO). These real-world data suggest a similar effectiveness of continuous and intermittent etanercept treatment in Greek patients with PsO.

The impact of complete clearance and almost complete clearance of psoriasis on quality of life: a literature review.

Psoriasis is a chronic skin condition with systemic manifestations that have a detrimental impact on a patient's quality of life, affecting social, psychological, and sexual aspects of life. Complete clearance of lesions is a meaningful end goal of treatment; however, it is often difficult for patients to achieve. In this literature review, we summarized past studies that compared patients who achieved complete clearance to those who were almost clear to highlight the effect of complete clearance on psychological distress, social stigma, self-esteem, and interpersonal relationships in adult patients with psoriasis. A literature search was performed through the PubMed database using the keywords "clearance of psoriasis", "complete clearance of psoriasis", "psychological impact psoriasis", "social impact psoriasis", and "stigma of psoriasis". Age (< 18) and language (only articles written in English were included) were the only exclusion criteria to include adult patients only. The information was then collected and evaluated to compare complete clearance and almost complete clearance of psoriasis. Of the patients with complete skin clearance (sPGA of 0), 61.4-91.1% reported a Dermatology Life Quality Index (DLQI) of 0, indicating no detectable impact of psoriasis on quality of life, compared to 45.7-48.3% who were almost clear. Patients who were completely clear felt psoriasis had less of an effect on their leisure activities and daily living compared to patients who were almost clear. Patient perceptions of disease severity also differed between the two groups, with the majority (65.5%) of those achieving complete clearance reporting a Psoriasis Symptom Inventory (PSI) of 0, which is consistent with their disease being "not at all severe", compared to 32.6% of those who were almost but not completely clear. While patients with complete clearance achieve a DLQI of 0 at a higher rate than those who have only almost complete clearance, the difference in the mean DLQI between patients with sPGA of 0 (completely clear) and sPGA of 1 (almost clear) is less than the minimal clinically important difference (MCID of 3-5) of the DLQI.

Quality of life in Nepalese Patients with Melasma: An Observational Cross-Sectional Study at a Tertiary Center.

Melasma is an acquired pigmentation disorder of the sun exposed parts of the body, particularly face. It is a significant cosmetic concern for the young adults, which is the most frequently affected age-group. Finding the level of impairment in quality of life in melasma patients and correlating with the severity. All consenting patients with melasma visiting our out-patient from December 2020 to June 2021 were enrolled. Clinical evaluation was done by the same single reviewer in all cases using modified Melasma Area and Severity Index. Dermatology Life Quality Index (Nepali version) was asked to complete to the patient. Data were collected and analyzed. Frequency and mean were calculated for all variables, comparison of means by Mann-Whitney U test and correlation analyses by Spearman's correlation test were performed. Females were 82.5%(99) of total cases. Among these 70.8%(85) were married, 68.3%(82) had family history of melasma and 65%(78) had centro-facial phenotype. Mean Dermatology Life Quality Index score was 10.25±0.54. Mean score of females was higher than that of males. The daily activities sub-domain was the worst affected with 50.67% of impairment. Females suffered significantly more than males in symptom and feeling sub-domain. Modified Melasma Area and Severity Index was significantly higher in males (7.12±.56 Vs. 5.66±.28). The severity and duration of melasma did not correlate to the quality of life. Melasma had a moderately negative impact in the quality of life of the patients. Females suffered more due to melasma. The clinical severity of melasma did not correlate with the quality of life impairment. Thus, psychological assessment to all the melasma patients seem to be an important aspect of management.

Impact of hidradenitis suppurativa-specific wound dressing system on patient quality of life and dressing-related pain: pilot study.

It is theorised that adhesive-free wound care developed specifically for patients with hidradenitis suppurativa (HS) can improve their quality of life (QoL). Our study aimed to investigate the impact of a novel wound care device on Dermatology Life Quality Index (DLQI) scores, and other factors related to experienced pain, time spent changing dressings, comfort, ease of use and body image. A 21-day, single-arm, unblinded, pilot trial was conducted to assess ease of use and the impact of effective wound care on various aspects of wound management in patients with HS. Participants were provided two trial garments and trial dressings as required, to use over a 21-day period in the home setting. A seven-item questionnaire and the DLQI questionnaire was completed on days 0, 7, 14 and 21. All 15 participants were female, aged >18 years old and with a diagnosis of HS. Mean DLQI score at baseline (day 0) was 19.3, which was reduced to 4.53 on day 21, a significant improvement in 100% of participants (p<0.001). High levels of dressing-related pain, assessed using an 11-point Visual Analogue Scale, reduced from 5.53 at baseline to 0.8 on day 21. Other significant improvements in terms of patient comfort, time spent on changing dressings, body confidence and the dressing's ability to retain exudate were also noted. The results illustrated the improvement made to study participants' day-to-day activities and QoL when effective HS-specific wound care products were provided. Wound care is an essential component in the treatment journey of patients.

Real world experience of brodalumab treatment in patients with moderate-to-severe plaque psoriasis in the Greek population: Results from an interim analysis of the BrIDGE study.

Brodalumab's clinical efficacy and favorable safety profile have been demonstrated during controlled clinical trials, but real-world data remain scarce. BrIDGE, an ongoing 104 week, observational, prospective, multicenter study conducted in Greece, enrolled moderate-to-severe plaque psoriasis patients, with body surface area (BSA) > 10 or psoriasis area severity index score (PASI) > 10 and dermatology life quality index (DLQI) > 10, based on European consensus, initiating brodalumab treatment as per routine clinical practice. This interim analysis includes evaluations 12-16 weeks following treatment initiation. Key efficacy endpoints included proportion of patients achieving static Physician's Global Assessment (sPGA) score of "clear/almost clear" (0/1) and a reduction ≥75%, 90%, 100% from baseline in PASI (PASI75, PASI90, and PASI100) at weeks 12-16. Other endpoints included time to achieve PASI100, changes in self-reported DLQI and psoriasis symptom inventory (PSI) at weeks 12-16. From 200 patients (mean age 51.4 years, 70% male, mean disease duration 13.8 years) enrolled, 72.8% achieved sPGA of 0/1, whereas 70.2%, 47.5%, and 32.0% achieved corresponding PASI75, PASI90, and PASI100 responses following 12-16 weeks of brodalumab treatment, according to the "as-observed" analysis. The mean time to achieve PASI100 was 13.7 ± 1.2 weeks for the 32% who achieved PASI100. Concurrent decreases in mean DLQI and PSI were observed. Furthermore, 90% adherence to brodalumab was noted and nine adverse events were reported. Brodalumab confers substantial clinical improvements short-term as reflected by high levels of skin clearance in moderate-to-severe plaque psoriasis patients within 12-16 weeks of treatment under everyday clinical conditions, followed by improvements in symptoms and quality of life and a favorable safety profile.

OMALIZUMAB TREATMENT OF CHRONIC SPONTANEOUS URTICARIA: EFFECTIVENESS AND SATISFACTION ASSESSED BY A REAL-WORLD SURVEY

<h3>Introduction</h3> Chronic spontaneous urticaria (CSU) is a debilitating disorder characterized by recurrent itch, hives, and angioedema. Omalizumab is approved for treatment of CSU and here we describe real-world effectiveness and satisfaction. <h3>Methods</h3> Physician-reported and patient-reported data were collected via the Adelphi CSU Disease Specific Programme™ (cross-sectional survey; United States; Q4:2020-Q3:2021). We describe outcomes for patients with moderate-to-severe CSU after initiation of omalizumab (OMA; n=129) versus other prescription medication (non-OMA; n=222). Bivariate analysis was conducted. <h3>Results</h3> Patients on OMA (mean(SD) 43.8(15.3) years; 66.7% female) were on their current treatment for mean(SD) 2.0(2.0) versus 1.2(1.5) years for patients on non-OMA (mean(SD) 38.8(13.7) years; 64.0% female). Following treatment initiation, proportion of patients experiencing moderate-to-severe severity declined to 15.6% and 34.7% for OMA and non-OMA groups (p<0.001), and more patients on OMA than non-OMA reported resolution of itch/hives (46.0/57.9% versus 27.4/39.2%; p<0.001). Patient-reported quality of life was better for OMA than non-OMA (mean(SD) Dermatology Life Quality Index score 2.4(3.6) versus 4.6(6.0); p<0.001). A greater proportion of patients on OMA (78.1%) versus non-OMA (55.4%) were satisfied the best control had been achieved with their current treatment (p<0.001). Satisfaction levels (of 8-10, range 0-10 with 10=extremely satisfied) with OMA were reported for symptom relief (by 87.7% of patients), quick onset of action (79.5%), tolerability (85.2%), convenience (59.0%), and dosing frequency (56.5%). <h3>Conclusions</h3> Patients with moderate-to-severe CSU at initiation of omalizumab experienced better treatment outcomes, reported better quality of life, and had a higher level of satisfaction with treatment than patients initiated on other prescription medications.

Ligelizumab improves angioedema, disease severity and quality-of-life in patients with chronic spontaneous urticaria

BackgroundDisease burden is particularly high in Chronic Spontaneous Urticaria (CSU) patients with angioedema, and patients whose signs and symptoms are inadequately controlled by H1-antihistamines need new treatment options. Here we report an exploratory analysis, from the ligelizumab Phase 2b study, investigating angioedema occurrence in patients with CSU and describe the changes in angioedema following treatment with ligelizumab, omalizumab, or placebo. MethodsData from the ligelizumab Phase 2b core (ligelizumab 72 mg, 240 mg, omalizumab 300 mg and placebo) and extension study (ligelizumab 240 mg) were used. Changes in Weekly Angioedema Activity Score (AAS7), the Dermatology Life Quality Index (DLQI), and Weekly Urticaria Activity Score (UAS7) among each time point were analyzed for each treatment arm. ResultsFrom a total of 297 patients analyzed, 165 (55.6%) reported angioedema occurrence at baseline, with mean AAS7 ranging 30.6—42.2 across treatment arms. At Week 12 of the core study 87.5%, 84.6%, 75.0%, and 61.0% of patients were angioedema free for ligelizumab 72 mg, 240 mg, omalizumab 300 mg, and placebo arms, respectively. In CSU patients with angioedema at baseline, the largest change from baseline in AAS7 score was observed with ligelizumab 72 mg (−31.9) at week 16 in the core study. Patients with angioedema had a higher mean DLQI at baseline (14.9—16.1) vs. patients without angioedema (10.6—12.0). In patients with angioedema, low AAS7 was significantly associated with complete response on UAS7 (UAS7 = 0) and complete normalization of DLQI (DLQI 0—1). ConclusionIn the Phase 2b study, ligelizumab effectively reduced angioedema and urticaria symptoms, and improved health related quality of life in patients with moderate-to-severe CSU. Clinicaltrails.gov NCT numberNCT02477332; NCT02649218.

Patient Use of Complementary and Alternative Medicine for Psoriasis Vulgaris and Factors Believed to Trigger the Disease: a Multicenter Cross-Sectional Study With 1621 Patients.

Due to the chronic recurrent nature of psoriasis vulgaris (PV) and lack of definitive treatment for the disease, patients often resort to alternative treatments. Physicians seem to have low awareness of this issue. To elicit the perceptions of 1,621 PV patients on complementary and alternative medicine (CAM) and examine factors reported to worsen PV. The patients sociodemographic characteristics, Psoriasis Area Severity Index (PASI), Dermatology Life Quality Index (DLQI), disease duration, and severity were recorded, and the patients CAM use was questioned in detail. The patients were also asked about factors that worsened PV and their experiences with a gluten-free diet. Of the patients, 56.51% had used CAM. The mean age, illness duration, PASI scores and DLQI of those using CAM were significantly higher. CAM use was significantly higher in those with facial, genital involvement, and arthralgia/arthritis. The patients mostly referred to CAM when PV became severe (46.4%). Of the CAM users, 45.52% used herbal topicals. The physicians of 67.03% did not inquire whether they used CAM. Of the participants, 37.73% considered that stress worsened their disease. Gluten-free diet did not affect PV symptoms in 52.22%. Patients CAM use is often overlooked by dermatologists. Our results showed that more than half the patients used CAM and did not share this information with their physicians. Therefore, the awareness of physicians should be increased and patients should be asked about the use of CAM and directed to the appropriate medical treatment options by physicians.

Major Clinical Features and Epidemic Characteristics of Erosive Vulvar Lichen Planus: A Retrospective Analysis of 40 Patients

Objective: A retrospective analysis of erosive vulvar lichen planus (EVLP) was performed to raise awareness on this chronic, deforming, and painful vulvar disease. Methods: This observational retrospective study involved 40 patients with EVLP among 1368 patients with vulvar disease from 2017 to 2020. The patients’ vulvar clinical features and extra-vulvar mucosal involvement were investigated. The patients’ pain and quality of life were evaluated with the numeric rating scale (NRS) and the Dermatology Life Quality Index (DLQI), respectively. Results: EVLP accounted for 2.9% (40/1,368) of all cases of vulvar disease, and the median age at onset was 42 years. Erosion mostly occurred on the labia minora and introitus. Half (20/40) of the patients had extra-vulvar mucosal involvement. Seventeen (42.5%) patients had oral lichen planus, and seven (17.5%) patients were diagnosed with vulvovaginal-gingival syndrome. The NRS score showed that 47.5% (19/40) of patients experienced mild pain whereas 12.5% (5/40) described the pain as severe. Thirty-one patients (77.5%, 31/40) had dyspareunia, and nine patients had aggravated pain after sexual intercourse. The mean DLQI score was 9.1 ± 6.0, with 37.5% (15/40) of patients indicating that EVLP had severely affected their lives. Conclusion: EVLP can affect the quality of women’s lives and cause severe deformations and painful architectural changes. The description of the characteristics of EVLP in this report will benefit the diagnosis and early treatment of this disease.

Hirsutism and Quality of Life of Women in Tertiary Care Center in Eastern Nepal

Background Hirsutism is excess terminal hair growth in women at androgen-dependent sites of the body and it has great impact on psychological and social aspects of their lives, thus affecting their quality of life (QoL). Several studies assessing the quality of life in hirsute women could be found in world literature but none in Nepalese literature. So, this study was undertaken for the assessment of the impact of hirsutism on the quality of life in Nepalese women.&#x0D; Objective To assess the effect of hirsutism on quality of life of women in a tertiary center of Eastern Nepal and its association with various socio-demographic and clinical parameters.&#x0D; Method A cross-sectional questionnaire-based study was conducted in 49 participants aged 10 to 49 years at the Department of Dermatology, B.P. Koirala Institute of Health Sciences. Clinically diagnosed hirsute females with modified Ferriman-Gallwey (mFG) score &gt; 8, were enrolled and asked to fill Dermatology Life Quality Index (DLQI) questionnaire in the Nepalese version.&#x0D; Result More than 57.2% of the study population was of age 20 to 29 years with a mean of 27.76±8.08 years. The mean Dermatology Life Quality Index score was 7.78±4.95. The moderate effect was seen in the majority of participants (36.7%) with a predominant effect upon aspects of life like daily activities and symptoms and feelings. Participants with higher mF-G score (22.15±3.82) had a very large effect on their quality of life. Younger unmarried women with a school education and having a longer duration of hirsutism were found to have a higher effect upon their quality of life. However, the association was not statistically significant.&#x0D; Conclusion Hirsutism had affected the quality of life moderately with predominant effect upon aspects like daily activities and symptoms and feelings. No significant association was elicited between severity of hirsutism and its effect on quality of life from our study.

The burden of symptomatic patients with chronic spontaneous urticaria: a real-world study in Korea.

Background/AimsChronic spontaneous urticaria (CSU) poses a considerable burden both on the quality of life (QoL) of individual patients and on healthcare systems. Real‑world data evaluating the disease burden of CSU are limited in this country. This study evaluated the disease burden and healthcare resource utilization (HRU) among symptomatic CSU patients.MethodsThis multicenter, noninterventional, retrospective, and cross-sectional study assessed CSU patients symptomatic for more than 6 months despite step-wise H1-antihistamine medications. Primary outcomes included Urticaria Activity Score over 7 days (UAS7) and Chronic Urticaria QoL scale (CU-QoL). Secondary outcomes included EuroQol 5-Dimension 5-Level (EQ-5D-5L), Dermatology Life Quality Index (DLQI), association of disease activity with QoL, medications used for the past 6 months, and HRU.ResultsFive hundred patients with CSU were enrolled. Mean disease duration was 3.7 years. Based on UAS7, 22.2% of patients were in well-controlled status and 31.2%, 28.4%, and 18.2% of them had mild, moderate, and severe disease, respectively. Mean CU-QoL and DLQI scores were 57.5 ± 29.7 and 10.2 ± 7.6, respectively, while the EQ-5D-5L utility score was 0.8 ± 0.2. H1-antihistamines were prescribed to 95% of patients, while omalizumab was prescribed to 33% of patients. Most patients (98%) had outpatient visits in the past 6 months. Negative correlations were noted between UAS7 and CU-QoL, EQ-5D-5L, EQ-5D-5L visual analog scale scores, but a positive correlation was noted with DLQI score (p < 0.001 for all). The number of outpatient department visits increased with disease activity (p = 0.001).ConclusionsCSU affects QoL, leading to increased HRU, particularly in patients with severe disease.

Effect of Melasma on Quality of Life of Patients using Dermatology Life Quality Index

Objective: To assess the effect of melasma on the Quality of Life (QoL) of patients using the Dermatology Life Quality Index (DLQI).&#x0D; Study Design: Cross-sectional study.&#x0D; Place and Duration of Study: Department of dermatology PAF Hospital, Jacobabad Pakistan, from Jun 2019 to 2020.&#x0D; Methodology: A total of 103 patients with melasma were enrolled in the study from the dermatology outpatient department after written informed consent. Patients of either gender aged 15 years and above were included in the study. Melasma Area and Severity Index assessed melasma severity. In addition, the impact on Quality of Life was assessed using the Dermatology Life Quality Index questionnaire.&#x0D; Results: Among the 103 patients, 67 (65%) were females, and 36 (35%) were male. The mean age of patients was 29.50±7.94 years and included 78 (75.7%) married and 25 (24.3%) unmarried individuals. Mean Melasma Area and Severity Index was 22.04±11.23, including 36 (35%) patients with mild, 43 (41.7%) moderate and 24 (23.3%) patients with severe disease, respectively. Overall mean Dermatology Life Quality Index of the sample was 11.25±7.78, while mean scores for the mild, moderate and severe diseases were 5.89±.58, 10.33±5.75 and 20.96±6.62, respectively (p=0.001), indicating that Quality of Life is significantly more impaired with increased disease severity.&#x0D; Conclusion: Melasma significantly affects the Quality of Life of the patients as measured by Dermatology Life Quality Index. The impact on Quality of Life is directly proportional to the severity of melasma assessed by the Melasma Area Severity Index.

Real-world clinical outcomes of treatment with brodalumab in patients with moderate-to-severe psoriasis: a retrospective, 24-month experience from four academic dermatology centers in Greece

Objective To assess the real-world clinical treatment outcomes with brodalumab in patients with moderate-to-severe plaque psoriasis in Greece. Materials and methods This was a longitudinal, retrospective, real-world analysis of data from medical records of 106 patients with moderate-to-severe plaque psoriasis, treated with brodalumab for up to 24 months at four University Dermatology Centers in Greece. Efficacy assessments of psoriasis severity [Psoriasis Area and Severity Index (PASI) and Body Surface Area affected (BSA) scores] and its impact on patients’ quality of life (QoL) [Dermatology Life Quality Index (DLQI) score] were evaluated at different timepoints up to 24 months. Results Treatment with brodalumab reduced both mean PASI (14.0–1.5, p < .001) and BSA scores (21.6–2.5, p < .001) across all visits. This effect was accompanied by reduction in mean DLQI score (12.8–2.1, p < .001) across all visits compared with baseline. Moreover, therapeutic efficacy was affected by prior biologic treatment exposure, as biologic naïve patients had greater reductions in all scores from baseline following treatment with brodalumab (numerical for mean PASI, significant for mean BSA and DLQI scores). Conclusion Brodalumab is effective long term, improving disease severity and health-related QoL in patients with moderate-to-severe plaque psoriasis in a real-world setting.

Clinicohistological and immunopathological features of patients with cutaneous lupus erythematosus at tertiary dermatology centre in Malaysia

Cutaneous lupus erythematosus (CLE) is a chronic, autoimmune skin disease with a wide spectrum of clinical presentations in different populations. To study the clinicohistological and immunological features of CLE in a multiethnic population and to identify the predictive factors of disease severity based on the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). This was a cross-sectional study of CLE conducted from March 2019 to February 2020. In total, 111 patients were recruited with a female/male ratio of 4.9 : 1. Acute CLE contributed 47.7%, followed by chronic CLE at 46.9% and subacute CLE at 5.4%. A large majority (84%) of patients had systemic lupus erythematosus. Of patients with chronic CLE, about 67.3% developed systemic involvement. Antinuclear antibody (ANA) was detected in 90.0%. Skin biopsy was taken from 42 patients and showed perivascular lymphocytic infiltration (95.2%), epidermal atrophy (47.6%) and hydropic degeneration of the basal layer (47.6%). Immunoglobulin deposition at the dermoepidermal junction was seen in > 40% of patients, predominantly in a granular pattern. Mean CLASI Total was 6.44 ± 7.70, while CLASI Activity (CLASI-A) was 2.75 ± 4.10 and CLASI Damage (CLASI-D) was 3.71 ± 4.76. Involved body surface area (BSA) was found to be an independent predictive factor for CLASI-A (OR = 1.34, P < 0.02). For CLASI-D, positive predictive factors were involved BSA (OR = 4.14, P < 0.001), discoid lupus erythematosus subtype (OR = 13.10, P = 0.001), cutaneous vascular disease (OR = 26.59; P = 0.014), scalp involvement (OR = 8.7, P < 0.01) and hypocomplementaemia (OR = 5.71, P < 0.5). Mean Dermatology Life Quality Index was 5.91 ± 5.34 and correlated significantly with disease severity. We observed a high percentage of patients with CLE with systemic manifestations and positive ANA result. More aggressive treatment of patients with positive predictive factors for severe disease combined with significant clinical activity may be warranted.

Burden of Moderate to Severe Atopic Dermatitis in Adults from France, Italy, and the UK: Patient-Reported Outcomes and Treatment Patterns

IntroductionModerate to severe atopic dermatitis (AD) is associated with a significant disease burden, impacting sleep, quality of life, and treatment needs. The aim of this study was to characterize disease burden and treatment patterns for adults with moderate to severe AD in three European countries: France, Italy, and the UK.MethodsThis retrospective analysis of adult patients with moderate to severe AD in Europe used medical records and physician/patient survey data collected in August 2019 to April 2020. Demographic and baseline disease characteristics, information on current comorbidities, disease flares, and current and previous treatments were collected by the physician. Patient-perceived burden was assessed using patient-reported outcome (PRO) questionnaires, which were completed on a voluntary basis and included the following instruments: Patient-Oriented Eczema Measure (POEM), Dermatology Life Quality Index (DLQI), EuroQol five-dimensional (EQ-5D), and Work Productivity and Activity Impairment (WPAI). Disease severity was subjectively assessed by physicians and was based on their own definition of the terms mild, moderate, and severe. Data were analyzed descriptively.ResultsThe physician-reported sample included 912 patients with moderate to severe disease from France (n = 314), Italy (n = 309), and the UK (n = 289); approximately 30% of patients provided PRO data. Across these countries, 22–41% of patients reported current flares; mean POEM and DLQI scores were 10.6–13.1 and 9.5–11.1, respectively, indicating a high disease burden. However, systemic therapy use was low (e.g., conventional systemics were used by 18–24% of patients). Physician-assessed disease severity did not fully align with EASI scores, indicating that factors in addition to skin signs are impacting AD severity.ConclusionPatients with moderate to severe AD report significant disease burden, highlighting unmet treatment needs, particularly with respect to the underuse of systemic treatments despite AD being a systemic disease and the associated disease burden.Supplementary InformationThe online version contains supplementary material available at 10.1007/s13555-022-00777-z.