Impact of different skin conditions on quality of life

Many skin conditions may have a strong impact on quality of life. The impact depends on several factors and in particular on the nature of the disease itself. The aim of the study was to describe the burden of several dermatological conditions on patients and to compare them.

Dermatological patients were recruited consecutively during the normal outpatient clinics of a large reference hospital. Quality of life data were collected using the Skindex-29. A short form of the questionnaire, the Skindex-17, was derived in order to simplify the presentation of results. The Skindex-17 has two subscales: symptoms and psychosocial.

Data were complete for 2478 patients and 2402 patients for the symptomatic and the psychosocial scale of Skindex-17, respectively. The different skin conditions were grouped into 32 categories. Three disease patterns could be recognized, according to quality of life impairment: 1) low symptomatic impairment and low psychosocial impairment: mild conditions such as nevi and benign skin neoplasms, but also melanoma; 2) low symptomatic impairment and high psychosocial impairment: diseases such as alopecia, hirsutism, vitiligo; 3) high symptomatic impairment and high psychosocial impairment: for example, psoriasis, pemphigus, lichen.

Specialty-specific quality of life questionnaires, such as the Skindex-29 or the Skindex-17, allow to evaluate differences among conditions. Such observations could be used by health policy makers, to show, for example, that some conditions affecting the appearance, even though not clinically severe, may have a strong impact on psychosocial life.