Measuring the quality of life of patients with skin disease

Abstract

The effect of a skin disease on a patient’s quality of life is often of more importance than the discomfort of having a rash or the presence of skin lesions. Clinical decisions on therapy often take this into account, and assessment of the effectiveness of new management techniques ought ideally to include formal measurement of quality of life and should represent the final common pathway in the treatment of skin diseases. Nevertheless, the concept of health-related quality of life in skin disease like other chronic conditions continues to generate interest and controversy both in respect of its relevance as a therapeutic outcome measure and the methodology used for its measurement. Many different methods are used to measure the clinical severity of skin disease¹⁴, such as the Psoriasis Area and Severity Index (PASI)¹⁰, but these do not tell us to what extent the disease influences the patient's functional behaviour, either physical and psychosocial. Thus, methods of health-related quality of life assessment are needed in dermatology for three reasons: (1) it provides an additional measure of disease status relevant to the patient for clinical decision-making, selection of treatment and monitoring; (2) it gives an ability to assess the effectiveness of both existing and novel management techniques; and (3) it provides an important comparator with systemic diseases when arguing for more resources for dermatology.