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Ardalan K, Zigler CK, Torok KS. Predictors of Longitudinal Quality of Life in Juvenile Localized Scleroderma. Arthritis Care Res (Hoboken) 2017; 69:1082-1087. [PMID: 27696700 DOI: 10.1002/acr.23101] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2015] [Revised: 09/07/2016] [Accepted: 09/20/2016] [Indexed: 11/05/2022]
Abstract
OBJECTIVE Localized scleroderma can negatively affect children's quality of life (QoL), but predictors of impact have not been well described. We sought to identify predictors of QoL impact in juvenile localized scleroderma patients. METHODS We analyzed longitudinal data from a single-center cohort of juvenile localized scleroderma patients, using hierarchical generalized linear modeling (HGLM) to identify predictors of QoL impact. HGLM is useful for nested data and allows for evaluation of both time-variant and time-invariant predictors. RESULTS The number of extracutaneous manifestations (ECMs; e.g., joint contracture and hemifacial atrophy) and female sex predicted negative QoL impact, defined as a Children's Dermatology Life Quality Index score >1 (P = 0.019 for ECMs and P = 0.002 for female sex). As the time since the initial visit increased, the odds of reporting a negative QoL impact decreased (P < 0.001). CONCLUSION Our results suggest that ECMs, sex, and time since initial visit are more predictive of QoL impact in localized scleroderma than cutaneous features. Further study is required to determine which ECMs have the most impact on QoL, which factors underlie sex differences in QoL in localized scleroderma, and why increasing the time since the initial visit appears to be protective. An improved understanding of predictors of QoL impact may allow for the identification of patients at risk of poorer outcomes and for the tailoring of treatment and psychosocial support.
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Affiliation(s)
- Kaveh Ardalan
- Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, Illinois
| | - Christina K Zigler
- Christina K. Zigler, MSEd, Kathryn S. Torok, MD: Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
| | - Kathryn S Torok
- Christina K. Zigler, MSEd, Kathryn S. Torok, MD: Children's Hospital of Pittsburgh, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Finlay A. Broader concepts of quality of life measurement, encompassing validation. J Eur Acad Dermatol Venereol 2017; 31:1254-1259. [DOI: 10.1111/jdv.14254] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 03/13/2017] [Indexed: 12/18/2022]
Affiliation(s)
- A.Y. Finlay
- Department of Dermatology and Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; Cardiff UK
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Shin J, Choi Y, Park EC, Lee KH, Hwang SY, Oh SH, Lee SG. Psychiatry outpatient visits by atopic dermatitis patients varying in the complexity of their prescriptions: A nationwide cohort study conducted from 2005 to 2013. Medicine (Baltimore) 2016; 95:e5411. [PMID: 27930517 PMCID: PMC5265989 DOI: 10.1097/md.0000000000005411] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The uncomfortable symptoms of atopic dermatitis (AD) often trigger psychological stress.We investigated the association between AD severity and outpatient visits to psychiatrists using Korean National Health Insurance claims data from 2004 to 2013.This was a retrospective cohort analysis; we estimated hazard ratios (HRs).Of the 266,182 subjects, 18,290 (6.9%) had a history of visiting a psychiatrist, and 25,419 (9.5%) were diagnosed with AD. Compared with the subjects without AD, subjects with AD had a higher HR for visiting a psychiatrist (3.70, 95% confidence interval [CI]:48 3.43-3.98), and this significantly increased as the complexity of the AD medications increased. Subjects who received topical treatments plus a systematic steroid (HR: 4.88, 95% CI: 4.51-5.27) and those who received topical treatments plus a systematic steroid plus a systematic calcineurin inhibitor (HR: 9.56, 95% CI: 4.29-21.28) had higher HRs compared with those without AD.Severe AD patients exhibited greater psychological stress than those without AD or with mild AD symptoms. Moreover, medication diversity may represent an efficient and low-cost method by which to identify a vulnerable population.
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Affiliation(s)
- Jaeyong Shin
- Department of Preventive Medicine
- Institute of Health Services Research, College of Medicine
- Department of Public Health, Graduate School
| | - Young Choi
- Institute of Health Services Research, College of Medicine
- Department of Public Health, Graduate School
| | - Eun-Cheol Park
- Department of Preventive Medicine
- Institute of Health Services Research, College of Medicine
- Department of Public Health, Graduate School
| | - Kwang Hoon Lee
- Department of Dermatology, Severance hospital, College of medicine
| | - Seo Young Hwang
- Department of Dermatology, Severance hospital, College of medicine
| | - Sang Ho Oh
- Department of Dermatology, Severance hospital, College of medicine
| | - Sang Gyu Lee
- Department of Hospital Management, Graduate School of Public Health, Yonsei University, Seoul, Korea
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Ali F, Cueva A, Vyas J, Atwan A, Salek M, Finlay A, Piguet V. A systematic review of the use of quality-of-life instruments in randomized controlled trials for psoriasis. Br J Dermatol 2016; 176:577-593. [DOI: 10.1111/bjd.14788] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/23/2016] [Indexed: 01/13/2023]
Affiliation(s)
- F.M. Ali
- Department of Dermatology and Academic Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; 3rd Floor Glamorgan House, Heath Park Cardiff CF14 4XN U.K
| | - A.C. Cueva
- Department of Dermatology and Academic Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; 3rd Floor Glamorgan House, Heath Park Cardiff CF14 4XN U.K
- Centro de la Piel; Quito Ecuador
| | - J. Vyas
- Department of Dermatology and Academic Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; 3rd Floor Glamorgan House, Heath Park Cardiff CF14 4XN U.K
| | - A.A. Atwan
- Department of Dermatology and Academic Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; 3rd Floor Glamorgan House, Heath Park Cardiff CF14 4XN U.K
| | - M.S. Salek
- School of Life and Medical Sciences; University of Hertfordshire; Hatfield U.K
- Institute for Medicines Development; Cardiff U.K
| | - A.Y. Finlay
- Department of Dermatology and Academic Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; 3rd Floor Glamorgan House, Heath Park Cardiff CF14 4XN U.K
| | - V. Piguet
- Department of Dermatology and Academic Wound Healing; Division of Infection and Immunity; School of Medicine; Cardiff University; 3rd Floor Glamorgan House, Heath Park Cardiff CF14 4XN U.K
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Pickett K, Loveman E, Kalita N, Frampton GK, Jones J. Educational interventions to improve quality of life in people with chronic inflammatory skin diseases: systematic reviews of clinical effectiveness and cost-effectiveness. Health Technol Assess 2016; 19:1-176, v-vi. [PMID: 26502807 DOI: 10.3310/hta19860] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Inflammatory skin diseases include a broad range of disorders. For some people, these conditions lead to psychological comorbidities and reduced quality of life (QoL). Patient education is recommended in the management of these conditions and may improve QoL. OBJECTIVES To assess the clinical effectiveness and cost-effectiveness of educational interventions to improve health-related quality of life (HRQoL) in people with chronic inflammatory skin diseases. DATA SOURCES Twelve electronic bibliographic databases, including The Cochrane Library, MEDLINE and EMBASE, were searched to July 2014. Bibliographies of retrieved papers were searched and an Advisory Group contacted. REVIEW METHODS Systematic reviews were conducted following standard methodologies. Clinical effectiveness studies were included if they were undertaken in people with a chronic inflammatory skin condition. Educational interventions that aimed to, or could, improve HRQoL were eligible. Studies were required to measure HRQoL, and other outcomes such as disease severity were also included. Randomised controlled trials (RCTs) or controlled clinical trials were eligible. For the review of cost-effectiveness, studies were eligible if they were full economic evaluations, cost-consequence or cost analyses. RESULTS Seven RCTs were included in the review of clinical effectiveness. Two RCTs focused on children with eczema and their carers. Five RCTs were in adults. Of these, two were of people with psoriasis, one was of people with acne and two were of people with a range of conditions. There were few similarities in the interventions (e.g. the delivery mode, the topics covered, the duration of the education), which precluded any quantitative synthesis. Follow-up ranged from 4 weeks to 12 months, samples sizes were generally small and, overall, the study quality was poor. There appeared to be positive effects on HRQoL in participants with psoriasis in one trial, but no difference between groups in another trial in which participants had less severe psoriasis. Carers of children in one RCT of eczema showed improvement in HRQoL; however, in a RCT evaluating a website intervention there were no demonstrable effects on HRQoL. Neither the RCT in those adults with acne nor the RCT in those adults with mixed skin conditions demonstrated an effect on HRQoL. One RCT reported subgroups with atopic dermatitis or psoriasis and education was effective for psoriasis only. Other outcomes also showed mixed results. It is unclear how clinically meaningful any of the observed improvements are. Three studies of cost-effectiveness were included. The interventions, comparators and populations varied across the studies and, overall, the studies provided limited information on cost-effectiveness. The studies did provide detailed information on resources and costs that could be useful to inform a future cost-effectiveness evaluation in this area. LIMITATIONS The application of the inclusion criterion around whether the interventions were aimed at improving HRQoL or the inference that they could improve HRQoL was difficult as information was rarely reported. CONCLUSIONS There is uncertainty regarding whether educational interventions addressing issues that could improve HRQoL in people with chronic skin conditions are effective. Tentative conclusions about the best approach to delivering these kinds of interventions are that face-to-face, group, sessions may be beneficial; however, text messages may also be effective. Delivery over a period of time and by a multidisciplinary team may also be associated with positive outcomes. There is uncertainty over whether or not educational interventions are cost-effective. STUDY REGISTRATION This study is registered as PROSPERO CRD42014007426. FUNDING The National Institute for Health Research Health Technology Assessment programme.
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Affiliation(s)
| | - Emma Loveman
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Neelam Kalita
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Geoff K Frampton
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
| | - Jeremy Jones
- Southampton Health Technology Assessments Centre (SHTAC), University of Southampton, Southampton, UK
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Prinsen CAC, Apfelbacher C. Measuring the impact of skin disease on children's quality of life. Br J Dermatol 2016; 174:720-1. [PMID: 27115588 DOI: 10.1111/bjd.14447] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C A C Prinsen
- Department of Epidemiology and Biostatistics, VU University Medical Centre and the EMGO+ Institute for Health and Care Research, De Boelelaan 1089a, 1081 HV, Amsterdam, the Netherlands.
| | - C Apfelbacher
- Medical Sociology, Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
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Olsen JR, Gallacher J, Finlay AY, Piguet V, Francis NA. Quality of life impact of childhood skin conditions measured using the Children's Dermatology Life Quality Index (CDLQI): a meta-analysis. Br J Dermatol 2016; 174:853-61. [PMID: 26686685 DOI: 10.1111/bjd.14361] [Citation(s) in RCA: 56] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/30/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND The Children's Dermatology Life Quality Index (CDLQI) is the most widely used instrument for measuring the impact of skin disease on quality of life (QoL) in children. OBJECTIVES To provide a meta-analysis of all published QoL scores for a range of childhood skin conditions. METHODS Studies using the CDLQI questionnaire to measure QoL in skin conditions were identified by searching Medline and Embase from January 1995 (CDLQI creation) to December 2014. Studies were grouped according to condition and baseline scores were combined using meta-analysis. RESULTS Sixty-seven studies using the CDLQI met the inclusion criteria. The overall estimated CDLQI scores for conditions reported more than once were [point estimate (95% confidence interval, CI), number of studies (n), score range]: atopic eczema [8·5 (7·1-9·8), n = 38, 0-29], acne [5·3 (1·9-8·5), n = 5, 0-30], alopecia [3·1 (0-7·7), n = 2, 0-6], molluscum contagiosum [3·5 (0·6-6·7), n = 5, 0-27], psoriasis [8·0 (3·9-12·1), n = 6, 0-29], scabies [9·2 (0·0-20·3), n = 2, 1-26], urticaria [7·1 (0-15·4), n = 2, 0-22], vitiligo [6·5 (0·7-12·2), n = 2, 0-20] and warts [2·9 (0-5·8), n = 4, 0-16]. Overall, the mean effect on QoL [weighted average CDLQI score 4·6 (95% CI 3·9-5·4)] for children with these conditions was small. However, many children were found to experience a very large impact on QoL (34% of children with atopic eczema, 10% with molluscum contagiosum and 1-5% with acne) in studies where the distributions of scores were provided. CONCLUSIONS Most skin conditions in children have a 'small' mean effect on QoL. However, the range is large and a significant proportion of children with many common skin conditions will experience a very large effect on quality of life.
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Affiliation(s)
- J R Olsen
- Institute of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8RZ, U.K
| | - J Gallacher
- Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, OX3 7JX, U.K
| | - A Y Finlay
- Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, U.K
| | - V Piguet
- Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, U.K
| | - N A Francis
- Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, CF14 4YS, U.K
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58
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Tuong W, Wang AS, Armstrong AW. Effect of Automated Online Counseling on Clinical Outcomes and Quality of Life Among Adolescents With Acne Vulgaris: A Randomized Clinical Trial. JAMA Dermatol 2015; 151:970-5. [PMID: 26017816 DOI: 10.1001/jamadermatol.2015.0859] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Effective patient education is necessary for treating patients with acne vulgaris. Automated online counseling simulates face-to-face encounters and may be a useful tool to deliver education. OBJECTIVE To compare the effectiveness of a standard educational website with that of an automated-counseling website in improving clinical outcomes and quality of life among adolescents with acne. DESIGN, SETTING, AND PARTICIPANTS Randomized clinical trial conducted between March 27, 2014, and June 27, 2014, including a 12-week follow-up in a local inner-city high school. Ninety-eight students aged at least 13 years with mild to moderate acne were eligible for participation. A per-protocol analysis of the evaluable population was conducted on clinical outcome data. INTERVENTIONS Participants viewed either a standard educational website or an automated-counseling website. MAIN OUTCOMES AND MEASURES The primary outcome was the total acne lesion count. Secondary measures included the Children's Dermatology Life Quality Index (CDLQI) scores and general skin care behavior. RESULTS Forty-nine participants were randomized to each group. At baseline, the mean (SD) total acne lesion count was not significantly different between the standard-website group and the automated-counseling-website group (21.33 [10.81] vs 25.33 [12.45]; P = .10). Improvement in the mean (SD) acne lesion count was not significantly different between the standard-website group and the automated-counseling-website group (0.20 [9.26] vs 3.90 [12.19]; P = .10). The mean (SD) improvement in CDLQI score for the standard-website group was not significantly different from that of the automated-counseling-website group (0.17 [2.64] vs 0.39 [2.94]; P = .71). After 12 weeks, a greater proportion of participants in the automated-counseling-website group maintained or adopted a recommended anti-acne skin care routine compared with the standard-website group (43% vs 22%; P = .03). CONCLUSIONS AND RELEVANCE Internet-based acne education using automated counseling was not superior to standard-website education in improving acne severity and quality of life. However, a greater proportion of participants who viewed the automated-counseling website reported having maintained or adopted a recommended anti-acne skin care regimen. TRIAL REGISTRATION clinicaltrials.gov Identifier: NCT02031718.
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Affiliation(s)
- William Tuong
- Department of Dermatology, University of California, Davis, Sacramento
| | - Audrey S Wang
- Department of Dermatology, University of California, Davis, Sacramento
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Geel M, Maatkamp M, Oostveen A, Jong E, Finlay A, Kerkhof P, Seyger M. Comparison of the Dermatology Life Quality Index and the Children's Dermatology Life Quality Index in assessment of quality of life in patients with psoriasis aged 16–17 years. Br J Dermatol 2015; 174:152-7. [DOI: 10.1111/bjd.14163] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/01/2015] [Indexed: 12/21/2022]
Affiliation(s)
- M.J. Geel
- Department of Dermatology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen the Netherlands
| | - M. Maatkamp
- Department of Dermatology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen the Netherlands
| | - A.M. Oostveen
- Department of Dermatology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen the Netherlands
| | - E.M.G.J. Jong
- Department of Dermatology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen the Netherlands
| | - A.Y. Finlay
- Department of Dermatology and Wound Healing Institute of Infection and Immunity Cardiff University School of Medicine Cardiff U.K
| | - P.C.M. Kerkhof
- Department of Dermatology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen the Netherlands
| | - M.M.B. Seyger
- Department of Dermatology Radboud University Medical Center PO Box 9101 6500 HB Nijmegen the Netherlands
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Chernyshov P, de Korte J, Tomas-Aragones L, Lewis-Jones S. EADV Taskforce's recommendations on measurement of health-related quality of life in paediatric dermatology. J Eur Acad Dermatol Venereol 2015; 29:2306-16. [DOI: 10.1111/jdv.13154] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2014] [Accepted: 03/19/2015] [Indexed: 11/28/2022]
Affiliation(s)
- P. Chernyshov
- Department of Dermatology and Venereology; National Medical University; Kiev Ukraine
| | - J. de Korte
- Department of Dermatology; Academic Medical Center - University of Amsterdam; Amsterdam The Netherlands
| | - L. Tomas-Aragones
- Aragon Health Sciences Institute; University of Zaragoza; Zaragoza Spain
| | - S. Lewis-Jones
- Department Dermatology; Ninewells Hospital & Medical School; Dundee Tayside Scotland
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Kouris A, Armyra K, Stefanaki C, Christodoulou C, Karimali P, Kontochristopoulos G. Quality of life and social isolation in Greek adolescents with primary focal hyperhidrosis treated with botulinum toxin type A: a case series. Pediatr Dermatol 2015; 32:226-30. [PMID: 25557249 DOI: 10.1111/pde.12480] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Primary hyperhidrosis, although extensively documented in adults, typically has onset that dates back to early childhood. It is an unpleasant and socially disabling problem for the affected child, but little attention has been paid to the disease in adolescents. The objective of the current study was to evaluate the effectiveness of botulinum toxin type A (BTXA) in adolescents with primary palmar and axillary hyperhidrosis and to determine its effect on quality of life and social isolation. Thirty-five individuals (17 girls, 18 boys) with moderate to severe palmar and axillary hyperhidrosis were treated with BTXA (onabotulinum). Patients were examined at baseline and 6 months after treatment. The Hyperhidrosis Disease Severity Scale (HDSS) was used to evaluate disease severity and the Children's Dermatology Life Quality Index (CDLQI) was used to assess quality of life. The University of California at Los Angeles loneliness scale (UCLA version 3) was used to assess personal perception of loneliness and social isolation. The median age of the participants was 14 years, and 48.6% were female. Twenty-one had palmar hyperhidrosis, and 14 had axillary hyperhidrosis. Total CDLQI and social isolation scores decreased significantly after treatment with BTXA (both p < 0.001). There was a significant difference between pre- and post-treatment levels of severity of hyperhidrosis. No statistically significant difference was documented for CDLQI and UCLA scores between boys and girls. Treatment of hyperhidrosis with BTXA resulted in improvement in quality of life, social skills, and activities.
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Affiliation(s)
- Anargyros Kouris
- Department of Dermatology and Venereology, Andreas Sygros Hospital, Athens, Greece
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van Oosterhout M, Janmohamed SR, Spierings M, Hiddinga J, de Waard-van der Spek FB, Oranje AP. Correlation between Objective SCORAD and Three-Item Severity Score Used by Physicians and Objective PO-SCORAD Used by Parents/Patients in Children with Atopic Dermatitis. Dermatology 2015; 230:105-112. [DOI: 10.1159/000367689] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/01/2023] Open
Abstract
<b><i>Background:</i></b> A self-assessment rating scale (SAS) is a good tool to assess the fluctuating disease severity and quality of life (QoL) in children with atopic dermatitis (AD). The European Task Force on Atopic Dermatitis created an SAS based on the Scoring Atopic Dermatitis (SCORAD) index, called the Patient-Oriented SCORAD (PO-SCORAD). <b><i>Objective:</i></b> The aim of our study was to measure the correlation between alternative systems such as the Objective SCORAD, the Three-Item Severity (TIS) score and the Objective PO-SCORAD. We also investigated the correlations between the objective severity assessments and QoL. <b><i>Methods:</i></b> In a specialized outpatient clinic, an observational prospective study was performed with children ≤16 years with AD. <b><i>Results:</i></b> Seventy-five children were included. A good and significant correlation was shown between Objective SCORAD and Objective PO-SCORAD: Spearman's ρ correlation (r<sub>s</sub>) = 0.63 (p < 0.001). The correlation with QoL was moderate, but still significant (r<sub>s</sub> = 0.41-0.61, p < 0.001). <b><i>Conclusion:</i></b> The Objective PO-SCORAD can be used for the evaluation of fluctuating AD and correlates significantly with the Objective SCORAD and the less time-consuming TIS score.
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Olsen JR, Gallacher J, Finlay AY, Piguet V, Francis NA. Time to resolution and effect on quality of life of molluscum contagiosum in children in the UK: a prospective community cohort study. THE LANCET. INFECTIOUS DISEASES 2014; 15:190-5. [PMID: 25541478 DOI: 10.1016/s1473-3099(14)71053-9] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Molluscum contagiosum is one of the 50 most prevalent diseases worldwide, but scarce epidemiological data exist for childhood molluscum contagiosum. We aimed to describe the time to resolution, transmission to household child contacts, and effect on quality of life of molluscum contagiosum in children in the UK. METHODS Between Jan 1, and Oct 31, 2013, we recruited 306 children with molluscum contagiosum aged between 4 and 15 years in the UK either by referral by general practitioner or self-referral (with diagnosis made by parents by use of the validated Molluscum Contagiosum Diagnostic Tool for Parents [MCDTP]). All participants were asked to complete a questionnaire at recruitment about participant characteristics, transmission, and quality of life. We measured quality of life with the Children's Dermatology Life Quality Index (CDLQI). Participants were prospectively followed up every month to check on their recovery from molluscum contagiosum and transmission to other children in the same household, until the child's lesions were no longer visible. FINDINGS The mean time to resolution was 13·3 months (SD 8·2). 80 (30%) of 269 cases had not resolved by 18 months; 36 (13%) had not resolved by 24 months. We recorded transmission to other children in the household in 102 (41%) of 250 cases. Molluscum contagiosum had a small effect on quality of life for most participants, although 33 (11%) of 301 participants had a very severe effect on quality of life (CDLQI score >13). A greater number of lesions was associated with a greater effect on quality of life (H=55·8, p<0·0001). INTERPRETATION One in ten children with molluscum contagiosum is likely to have a substantial effect on their quality of life and therefore treatment should be considered for some children, especially those with many lesions or who have been identified as having a severe effect on quality of life. Patients with molluscum contagiosum and their parents need to be given accurate information about the expected natural history of the disorder. Our data provide the most reliable estimates of the expected time to resolution so far and can be used to help set realistic expectations. FUNDING Wales School of Primary Care Research (WSPCR) and Cardiff University.
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Affiliation(s)
- Jonathan R Olsen
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK.
| | - John Gallacher
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK
| | - Andrew Y Finlay
- Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, Cardiff University and University Hospital of Wales, Cardiff, Wales, UK
| | - Vincent Piguet
- Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, Cardiff University and University Hospital of Wales, Cardiff, Wales, UK
| | - Nick A Francis
- Cochrane Institute of Primary Care and Public Health, Cardiff University, Cardiff, Wales, UK
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Ramien ML, Ondrejchak S, Gendron R, Hatami A, McCuaig CC, Powell J, Marcoux D. Quality of life in pediatric patients before and after cosmetic camouflage of visible skin conditions. J Am Acad Dermatol 2014; 71:935-40. [DOI: 10.1016/j.jaad.2014.07.029] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2014] [Revised: 07/11/2014] [Accepted: 07/20/2014] [Indexed: 10/24/2022]
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65
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Finlay A. Quality of life in dermatology: after 125 years, time for more rigorous reporting. Br J Dermatol 2014; 170:4-6. [DOI: 10.1111/bjd.12737] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A.Y. Finlay
- Department of Dermatology and Wound Healing; School of Medicine; Cardiff University; Cardiff U.K
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