How Skin Disease Affects Peoples’ Lives

Many patients with skin disease experience a major impact on their quality of life, although some continue their lives as normal (Figure 5.1). Chronic inflammatory skin diseases such as severe psoriasis, eczema, acne and hidradenitis suppurativa cause the greatest life quality impairment and disfiguring diseases such as vitiligo and alopecia areata also cause major problems. Virtually all aspects of patients’ lives can be affected, including home care, shopping, choice of clothes, social activities, sport, study, work, personal and sexual relationships. Patients experience itchiness and embarrassment, and the treatment itself, especially if topical, can add to the burden.

Understanding Patient’s Quality of Life Impact Helps Clinical Practice

One of the main reasons that people seek help for their skin disease is that it is disrupting their lives. When taking clinical decisions in dermatology, clinicians are influenced by how severely they think the patient’s life is affected. If you understand this impact accurately, your clinical decisions will be more appropriate. Simply ask ‘How is your skin disease affecting your life at the moment?’ Formal measurement with a quality of life questionnaire may be helpful (e.g. when considering prescribing a systemic therapy).

How to Measure the Impact of Skin Disease on Life Quality

There are dermatology-specific questionnaires such as the Dermatology Life Quality Index (DLQI) or Skindex, disease-specific questionnaires, such as the Psoriasis or Acne Disability Indices, and generic measures that can be used across all diseases (Table 5.1).