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Klein C, Oji V, Sommer R, Augustin M, Ständer S, Salzmann S, Kiekbusch K, Bodes J, Danzer MF, Traupe H, Fischer J, Steinke S, Süßmuth K. Personal, financial and time burden in inherited ichthyoses: A survey of 144 patients in a university-based setting. J Eur Acad Dermatol Venereol 2024. [PMID: 38523469 DOI: 10.1111/jdv.19804] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Accepted: 11/14/2023] [Indexed: 03/26/2024]
Abstract
BACKGROUND Patients with inherited ichthyosis suffer from scaling due to mutations affecting the epidermal barrier. Symptomatic treatment with ointments, bathing and mechanical scale removal can alleviate the disease, but therapy is time and cost intensive. OBJECTIVES We investigated costs, time and disease burden of ichthyoses. The study addresses difficulties of the healthcare situation for patients with ichthyoses and reveals potential improvements. MATERIALS AND METHODS We developed a questionnaire addressing time and financial effort for the treatment. Additionally, we collected data of the Dermatology Life Quality Index (DLQI) and the Pruritus Life Quality (5PLQ) questionnaires to determine the impact of ichthyosis and associated pruritus on quality of life (QoL). RESULTS We recruited 144 patients with ichthyosis (median age: 23; 53.5% female) from the Department of Dermatology in Muenster (Germany) and the German patient support group including common, rare and syndromic subtypes. Eighty-seven percent reported applying topical therapeutics at least once per day, 66.4% several times with an overall median duration of 15 min. Highest single expenditure of time was due to balneotherapy (n = 115; median bathing time: 40 min). In 81.9%, the health insurance did not completely cover the costs for topical treatment causing additional financial burden to the patient with a median of 71 € per quarter, herein creams being the largest cost factor (50 €). Patients with Netherton syndrome showed the highest median expenditure (170 €). The QoL impairment under treatment was moderate (median DLQI: 8.5 points). Pruritus was prevalent in 79.9% and showed a distinct impact on QoL (median 5PLQ: 7.5 points) without any significant difference between the subtypes (p = 0.37). CONCLUSION Patients suffering from ichthyoses have a large and lifelong overall burden in mild and severe subtypes. Since continuous topical treatment is required, financial and psychosocial support needs to be considered beyond dermatological care.
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Affiliation(s)
- C Klein
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - V Oji
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Hautarztpraxis am Buddenturm, Münster, Germany
| | - R Sommer
- German Centre for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - M Augustin
- German Centre for Health Services Research in Dermatology (CVderm), Institute for Health Services Research in Dermatology and Nursing, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - S Ständer
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Center of Chronic Pruritus, University Hospital of Münster, Münster, Germany
- Section Pruritus Medicine, Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - S Salzmann
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - K Kiekbusch
- Support Group "Selbsthilfe Ichthyose e. V.", Mittenwalde, Germany
| | - J Bodes
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - M F Danzer
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - H Traupe
- Department of Dermatology, University Hospital of Münster, Münster, Germany
| | - J Fischer
- Medical Center, Faculty of Medicine, Institute of Human Genetics, University of Freiburg, Freiburg, Germany
| | - S Steinke
- Department of Dermatology, University Hospital of Münster, Münster, Germany
- Hautarztpraxis am Hohenzollernring, Münster, Germany
- Medical School OWL, University of Bielefeld, Bielefeld, Germany
| | - K Süßmuth
- Department of Dermatology and Allergology, Helios Klinikum Berlin-Buch, Campus of Medical School Berlin, Berlin, Germany
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