白癜风患者的临床调查和生活质量评价

目的:探讨白癜风患者的临床特征,并应用世界卫生组织生活质量测定量表简表(WHOQOL-BREF)中文版和皮肤病生活质量指数粤语版(DLQI-C)两个量表,评价患者的生活质量。方法:以痤疮患者作为对照组,采取调查问卷形式进行,面对面调查已确诊为白癜风和痤疮的两组患者。问卷内容包括人口学资料、疾病临床特征和量表。结果:入组的120例白癜风患者共交回100份有效问卷,其临床分型以局限型和散发型为主,且暴露部位多有白斑。两组患者之间的WHOQOL-BREF得分及其各领域得分的差异均无统计学意义;而白癜风组的DLQI得分高于痤疮组,但差异无统计学意义,对其六个方面的比较发现,仅休闲和工作学习两方面的差异有统计学意义。结论:白癜风的发病年龄多在10-30岁,且好发于暴露部位,严重影响患者的生活质量,WHOQOL-BREF中文版和DLQI粤语版的评价结果提示白癜风患者与痤疮患者的生活质量相当。     

面部痤疮患者两种生活质量量表的考评

目的了解Cardiff痤疮伤残指数(CADI)和面部痤疮特异性生活质量调查问卷(Qol-acne)两种痤疮量表在国内临床的适用性。方法在知情同意的前提下,应用两量表对66例面部痤疮患者进行生存质量的调查,并分析两量表的信度、效度,并对两量表的得分进行相关分析。结果两量表的信度、效度均较好。两量表得分呈负相关(γ=-0.854,P0.001),即CADI得分越高Qol-acne得分越低。结论两量表均具有较好的信度及效度,能作为我国面部痤疮患者生活质量的测评工具。临床医师可以根据实际情况选择合适的量表对面部痤疮患者进行生活质量的评估。     

斑秃患者生活质量评估及皮肤病生活质量指数的信度分析及因子分析

目的:探讨斑秃(AA)对患者生活质量的影响,分析皮肤病生活质量指数(DLQI)在评估患者生活质量时的信度及因子结构。方法:采用DLQI量表评估AA患者的生活质量,并用信度分析及因子分析评估DLQI的信度及因子结构。结果:共调查了168例AA患者,DLQI得分为0~26分,平均为(6.82±5.85)分。DLQI评分与患者的病程、脱发面积、斑秃类型、拉发试验、甲改变及应激事件等6个因素有关。DLQI量表信度分析显示,整体量表的Cronbach系数α=0.876(0.7),删除问题l,α达最大值0.886。因子分析显示,DLQI量表用于测评AA时,特征值1的因子有2个,累计贡献率达59.58%。结论:AA对患者的生活质量有中等程度的影响。DLQI可以用来评估AA患者的生活质量,且具有较好的信度和效度。     

基于寻常性银屑病患者报告结局评价量表的研制及其信度和效度评价

目的研制基于寻常性银屑病患者报告以主症为疗效评价指标的临床结局评价量表(寻常性银屑病主症量表),并评价其信度和效度。方法通过文献研究、专家共识、小组反复讨论制定寻常性银屑病主症量表初版,通过进行现场问卷调查进行信度和效度分析。信度分析主要采用克朗巴赫α系数测量内部一致性信度,并采用探索性因子分析方法考评量表的效度,采用PASI分级为效标评价量表的效标关联度。结果发放213份量表,回收率为99.5%,完成率为98.6%。重测信度Spearman平均相关系数0.88(P0.01),内在一致性分析克朗巴赫α系数为0.86(13个条目)、0.87(14个条目);结构效度分析,13个条目的因子分析共提取了2个公因子,累计因子贡献率为51.28%(KMO=0.87,x±s=914.26,P0.001);14个条目的因子分析共提取了4个公因子,累计因子贡献率为70.42%,(KMO=0.75,x±s=334.06,P0.001);效标关联度分析,13个条目的量表与PASI分为轻中重度分级(PAIS7","7≤PASI≤12","PASI12")评分之间的Spearman相关系数为r=0.26,P0.05。结论构建的寻常性银屑病主症量表有14个条目,且具有良好的信度和效度,这可能成为中医药治疗寻常性银屑病诊疗评价的补充工具。     

中国银屑病患者生活质量量表的编制与考评

目的:编制银屑病患者生活质量量表(psoriasis quality of life scale,PQOLS),并验证该量表信度和效度。方法:根据WHO对生活质量的定义提出理论框架,通过文献回顾和专家咨询的方式编制PQOLS测试版。然后采用初始量表测定银屑病患者的生活质量,根据结果对条目筛选,形成PQOLS的正式版。结果:通过文献回顾和专家咨询建立包含40个条目的备选条目池。通过条目筛选,最终形成了含22个条目的PQOLS,包括疾病、心理、生理、社会4个维度。对136例患者进行测试结果表明:量表各维度及整个量表的Cronbachα均0.8,Sperman-Brown系数均0.7;因子分析发现单因素能够代表量表的大多数因子;PQOLS与皮肤病生活质量指数(DLQI)的Pearson相关系数为0.821;PQOLS总分与银屑病皮损面积和严重程度指数(PASI)值的相关系数为0.506,生活质量与病情严重度呈显著负相关。结论:编制的PQOLS具有较好的信度、效度,适用于银屑病患者生活质量的测评。     

慢性皮肤病对患者生活质量的影响

采用简体中文版DLQI量表,对132例慢性荨麻疹、慢性湿疹、浅表真菌感染、白癜风、银屑病、痤疮等慢性皮肤病患者的生活质量进行调查。结果:对患者生活质量的影响从大到小依次为:银屑病、慢性荨麻疹、慢性湿疹、浅表真菌感染、痤疮和白癜风。慢性皮肤病不同程度的影响了患者的生活质量。     

痤疮患者生存质量量表的考评

目的探讨中文版皮肤病生活质量表(DQOLS)和Cardiff痤疮伤残指数(CADI)在国内的适用性。方法对120例成年女性痤疮患者进行生存质量的调查,分析信度、效度、反应度。结果两量表的信度、效度均较好,反应度均无统计学意义。结论两量表均具有较好的信度及效度,进行部分修改后能作为我国痤疮患者生存质量的测评工具,但是量表的反应度有待进一步研究。     

中文版荨麻疹控制评分量表及信效度验证

【摘要】 目的 翻译荨麻疹控制评分（UCT），并检验该量表的信效度、敏感性以及筛选准确性。方法 经过翻译、回译和文化调试，确定荨麻疹控制评分量表的条目。应用该量表调查51例慢性自发性荨麻疹（CSU）、41例慢性诱导性荨麻疹（CIndU）患者和11例CSU合并CIndU患者。入组后8周内，81例使用抗组胺药治疗，8例使用奥马珠单抗治疗，14例抗组胺药联合奥马珠单抗治疗。入组时和入组后第4、8周时，用皮肤病学生活质量指数（DLQI）、荨麻疹活动评分（UAS）评估生活质量损害和疾病活动情况。采用Cronbach′s α系数评估问卷内部一致性信度。通过与DLQI、UAS28评分比较，检验中文版UCT的聚合效度、已知族群效度、敏感性及筛选准确性。结果 中文版UCT包含4个条目，回顾性评价过去4周内疾病的临床症状和体征、对生活质量的影响、治疗效果和总体疾病控制情况。CSU组UCT量表各条目得分的Cronbach′s α系数为0.886 ~ 0.945，CIndU组为0.834 ~ 0.958。入组时，CSU组与CIndU组UCT与DLQI评分显著负相关（rs值分别为-0.672，-0.578，均P＜0.01）。第4周和8周时，CSU组UCT与UAS28、DLQI评分均呈显著负相关（4周：rs值分别为-0.654、-0.829，均P＜0.01；8周：rs值分别为-0.717、-0.765，均P＜0.01），CIndU组UCT与DLQI评分亦显著负相关（rs值分别为-0.834、-0.778，均P＜0.01）。CSU组第4周与第8周之间UCT变化量与UAS变化量显著相关（rs = -0.569，P＜0.01）；与入组时比较，第4、8周时 UCT变化量与相应DLQI评分变化量显著相关（rs值分别为-0.693、-0.447，均P＜0.01）。对于CIndU组，与入组时比较，第4周与第8周时UCT变化量与DLQI变化量亦显著相关（rs值分别为-0.615、-0.408，均P＜0.01）。不同UAS、DLQI评分组间UCT评分差异均有统计学意义（均P＜0.05）。 结论 中文版UCT是有效、可靠的CSU和CIndU患者的临床管理工具，可用于评估疾病控制情况，在一定程度上反映疾病活动度及疾病相关生活质量。     

阿达帕林凝胶联合阿奇霉素间歇冲击疗法治疗中重度寻常型痤疮的临床观察

目的:观察阿达帕林凝胶联合阿奇霉素间歇冲击疗法治疗中重度寻常型痤疮的临床疗效及对患者生活质量的影响。方法:将70例中重度寻常型痤疮患者随机分成两组,对照组35例,给予阿奇霉素分散片口服,0.5 g/次,1次/天,每周连服3天后停药4天;治疗组35例,在对照组基础上给予外用阿达帕林凝胶,每晚睡前用1次。治疗前后采用皮肤病生活质量指数(DLQI)量表进行生活质量调查,比较两组用药1月、2月后的综合临床疗效。结果:治疗1月后,治疗组有效率45.71%,对照组有效率37.14%,差异无统计学意义(P>0.05)。治疗2月后,治疗组有效率82.86%,对照组有效率65.71%,差异有统计学意义(P<0.05);两组治疗后生活质量指数总分均较治疗前下降(P均<0.05),但以治疗组下降明显,两组治疗后生活质量指数总分比较,差异有统计学意义(P<0.05)。结论:阿达帕林凝胶联合阿奇霉素间歇冲击疗法治疗中重度寻常型痤疮的临床疗效显著,患者依从性好,生活质量水平得到明显改善。     

慢性荨麻疹患者生活质量评估及皮肤病生活质量指数的因子分析和信度分析

目的 探讨慢性荨麻疹（CU）对患者生活质量的影响,分析皮肤病生活质量指数（DLQI）在评估CU患者生活质量时的因子结构及信度。方法 用DLQI测量CU患者的生活质量,用因子分析及信度分析评估DLQI的因子结构及信度。结果 调查85例门诊就诊的慢性荨麻疹患者,13例因合并其他疾病或未完全回答DLQI的问题而被剔除。72例CU患者年龄（33.43 ± 0.90）岁,病程中位数6个月。DLQI评分为1 ~ 23,平均9.46 ± 0.61,DLQI评分与患者的年龄、性别、病程间相关性无统计学意义。CU对生活质量影响最显著的是症状与感受（50%）,其次为工作和学习（40.67%）。因子分析显示,DLQI量表用于测评CU时,特征值 > 1的因子有2个。信度分析显示F = 31.88（P < 0.01）,Hotelling T2检验,F = 29.87（P < 0.01）,整体量表Cronbach α = 0.836,删除问题1,α达最大值0.849。结论 CU对患者的生活质量有中等程度的影响。DLQI可以用来测评CU患者的生活质量,结果的可信度较高。     

Cultural Adaptation of the Cardiff Acne Disability Index to a Hindi Speaking Population: A Pilot Study

Background:

Acne vulgaris is known to impair many aspects of the quality of life (QoL) of its patients.

Aim:

To translate the Cardiff Acne Disability Index (CADI) from English into Hindi and to assess its validity and reliability in Hindi speaking patients with acne from India.

Methods:

Hindi version of CADI, translated and linguistically validated as per published international guidelines, along with a previously translated Hindi version of dermatology life quality index (DLQI) and a demographic questionnaire were administered to acne patients. The internal consistency reliability of the Hindi version of CADI and its concurrent validity were assessed by Cronbach''s alpha co-efficient and Spearman''s correlation co-efficient respectively. Construct validity was examined by factor analysis. Statistical analysis was carried out using the Statistical Package for the Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, IL, USA) for Windows.

Results:

One hundred Hindi speaking patients with various grades of acne participated in the study. Hindi version of CADI showed high internal consistency reliability (Cronbach''s alpha co-efficient = 0.722). Mean item-to-total correlation co-efficient ranged from 0.502 to 0.760. Concurrent validity of the scale was supported by a significant correlation with the Hindi DLQI. Factor analysis revealed the presence of two dimensions underlying the factor structure of the scale.

Conclusion:

Hindi CADI is equivalent to the original English version and constitutes a reliable and valid tool for clinical assessment of the impact of acne on QoL.     

Effects of isotretinoin on social anxiety and quality of life in patients with acne vulgaris: a prospective trial

Social anxiety is common in acne patients and the effects of isotretinoin treatment on social anxiety symptoms have not yet been thoroughly investigated. The aim of the study was to assess the effects of isotretinoin treatment on the quality of life and social anxiety symptoms in a group of acne vulgaris patients. The Liebowitz Social Anxiety Scale (LSAS) and Short Form-36 (SF-36) were administered to 39 (24 female and 15 male) patients with acne vulgaris who accepted isotretinoin treatment and agreed to participate in the study. The severity of acne was evaluated using the Global Acne Grading System. Thirty patients completed 6-month treatment with oral isotretinoin at 0.5-1.0 mg/kg daily doses. Measurements were repeated at the end of 6 months. Acne significantly improved over time in the study group. The mean performance avoidance score in LSAS and mean pain and social functioning scores in SF-36 were significantly better at the end of isotretinoin treatment. In conclusion, isotretinoin treatment improves the quality of life and social anxiety symptoms in acne patients.     

The impact of acne vulgaris on the quality of life and psychologic status in patients from upper Egypt

Background  Acne vulgaris is a common skin disease. Although neither life threatening nor physically debilitating, acne can severely affect social and psychologic functioning.
Aim  To study the overall impact of acne vulgaris on the quality of life and psychologic functioning of patients in Egypt.
Methods  One hundred and fifty patients with acne vulgaris and 50 healthy controls were evaluated. Acne patients were evaluated using the Dermatology Life Quality Index (DLQI), Culture Free Self-Esteem Inventory – Adult Version (CFSEI-AD), and Symptom Check List-90 – Revised (SCL-90-R). The controls were evaluated using SCL-90-R and CFSEI-AD.
Results  The mean DLQI scores of male acne patients were found to be higher than those of female patients with regard to symptoms and feelings, daily activities, personal relationships, and treatment; however, the differences were significant for leisure ( P  = 0.005) and total score ( P  = 0.022) only. The CFSEI-AD score of patients was significantly lower than that of controls ( P  = 0.001). Acne patients had significantly higher scores than controls in all items of the SCL-90-R. Significant positive correlations were found between the duration and severity of illness and DLQI and SCL-90-R scores. There was a significant negative correlation between the duration and severity of acne and CFSEI-AD scores.
Conclusion  Acne vulgaris has a significant effect on the quality of life. Our results highlight the importance of recognizing psychiatric comorbidity in acne patients.     

126例皮肤患者指甲中锌铜铁镁锰钙的含量

本文采用原子吸收分光光度仪检测了成都地区15例健康人和37例痤疮、30例白癜风、28例斑秃、16例慢性荨麻疹和15例男型秃发患者指甲中锌、铜、铁、镁、锰、钙的含量。结果表明,痤疮、白癜风、斑秃患者甲中锌含量显著低于健康人(P<0.05或P<0.025),慢性荨麻疹患者甲中锌、铜含量显著低于健康人(P<0.025)。经用苷草锌治疗,其效果对痤疮患者明显,对斑秃患者次之,对白癜风和慢性荨麻疹患者未见效果。     

Which factors influence quality of life in acne patients?

Background The factors that impact quality of life in acne patient are not fully understood. Objective The purpose of this study was to assess the relationship between quality of life with (i) acne severity; (ii) the duration of this cutaneous disease; and (iii) the gender. Methods Leeds scale to quantify acne severity, and Assessment of the Psychological and Social Effects of Acne (APSEA) score to evaluate quality of life were used. An unselected consecutive group of 50 males and 50 females affected by facial acne filled in the APSEA questionnaire during the first visit and after 3 months of treatment. Results (i) At the beginning of the treatment, APSEA score correlated with acne severity, but at the end of it, the reduction of APSEA score was less marked than the reduction of acne severity. (ii) Acne duration does not significantly influence APSEA score. (iii) Before treatment, acne severity was comparable between females and males, whereas APSEA score was significantly higher in females than in males. Conclusion The quality life of acne patients could be influenced by social and emotional factors. The discrepancy of the results reported in literature regarding the correlation of the quality of life with acne severity and duration probably depends on the sensitivity and specificity of the questionnaire used to assess the quality of life. Among the different available scores to measure quality of life in acne patients, in the authors’ experience, APSEA score is a valuable one.     

Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study

Background

Vitiligo and acne vulgaris, commonly affecting the face, have significant psychological effects and impair the quality of life of the affected individuals. Because of their negative effect on physical appearance, these conditions may act as a potential barrier to social relationships and cause social anxiety.

Objective

The objective of the study was to investigate the social anxiety, quality of life, anxiety, and depression levels of acne and vitiligo patients with facial involvement and compare these levels with healthy controls.

Methods

Thirty-seven vitiligo and 37 acne patients, aged older than 18 years, with facial involvement and 74 age- and sex-matched healthy control subjects were included in the study. The patients and healthy controls were asked to complete the Liebowitz Social Anxiety Scale, the Hospital Anxiety and Depression Scale, and the Dermatology Life Quality Index. Disease severity was evaluated both objectively by the physician and subjectively by the patients using a visual analog scale.

Results

Social anxiety, depression, and anxiety levels of vitiligo and acne patients were significantly higher than healthy controls (p < 0.05). Quality of life was impaired in both patient groups (Dermatology Life Quality Index scores for vitiligo: 5.6 ± 5.1; acne: 6.4 ± 6.2). There was no correlation between psychiatric scale scores and disease severity. Quality of life was negatively correlated with social anxiety and depression levels in both patient groups in our study.

Conclusion

Vitiligo and acne patients had higher levels of social anxiety, anxiety, and depression compared with healthy control subjects. Considering that increased psychosocial morbidity was regardless of age, sex, and disease severity and was correlated with quality of life impairment, evaluation of the psychosocial morbidity, in particular social anxiety, may be valuable in all vitiligo and acne patients.

     

Quality of life,self-esteem and psychosocial factors in adolescents with acne vulgaris

Background

Dermatological diseases, among which acne vulgaris, have psychological impact on the affected generating feelings of guilt, shame and social isolation.

Objectives

To compare quality of life, self-esteem and other psychosocial variables amongst adolescents with and without acne vulgaris, and between levels of severity.

Methods

Cross-sectional observational study in a sample of 355 high school students from the city of João Pessoa. Data collection was performed with questionnaires and clinical-dermatological evaluation. The primary variables were the incidence of AV; quality of life, set by the Children''s Dermatology Quality of Life Index and Dermatology Quality of Life Index; and self-esteem, measured by the Rosenberg Self-Esteem Scale. For calculation of statistical tests, we used the SPSS 20.0 software, considering p=0.05.

Results

The sample, with an average age of 16, showed 89.3% prevalence of acne vulgaris. The most prevalent psychosocial issue was "afraid that acne will never cease", present in 58% of affected youth. The median score of Quality of Life in Children''s Dermatology Index was different amongst students with and without acne vulgaris (p=0.003), as well as the Quality of Life in Dermatology (p=0.038) scores, so that students with acne vulgaris have worse QoL. There was a correlation between the severity of acne vulgaris and worse quality of life. Self-esteem was not significantly associated with the occurrence or severity of acne vulgaris.

Conclusions

acne vulgaris assumes significance in view of its high prevalence and the effect on quality of life of adolescents, more severe at the more pronounced stages of disease (p<0.001). The psychosocial impact of acne vulgaris should be valued in the management of patients with this condition.     

青年男性寻常痤疮患者膳食生糖负荷水平与皮损严重程度间的相关性研究

目的 通过调查青年男性寻常痤疮患者的膳食生糖负荷水平（GL）,评估其与寻常痤疮皮损严重程度间的相关性,为寻常痤疮综合治疗提供参考。方法 使用痤疮综合分级系统（GAGS）评价患者皮损严重程度。使用食物频率问卷及24 h膳食回顾问卷评估GL水平。方差分析及t检验分析GL及BMI在各组间的差异,并对BMI和GL的影响因素进行Logistic回归分析。结果 99例19 ~ 24岁男性寻常痤疮患者参与本次研究,Logistic回归结果显示,GL是体质指数（BMI）的影响因素,GL越高BMI越容易超标（回归系数β = 1.119,P < 0.05,OR = 3.062,95%置信区间：1.044 ~ 8.986）。未发现GL的影响因素。病程 ＞ 6个月组GL显著高于 ≤ 6个月组（t = 2.947,P < 0.01）;两组间BMI差异无统计学意义（t = 0.798,P > 0.05）。GL在不同GAGS组间差异有统计学意义（F = 76.296,P ＜ 0.01）,≥ 31分组高于19 ~ 30分组（P ＜ 0.01）和1 ~ 18分组（P ＜ 0.01）,19 ~ 30分组高于1 ~ 18分组（P ＜ 0.01）;各组间BMI差异无统计学意义（F = 3.142,P > 0.05）。结论 GL水平与青年男性寻常痤疮患者皮损严重程度及病程正相关。     

皮肤科门诊女性痤疮患者的心理状态及生活质量调查

 目的: 调查皮肤科门诊青春期及成人期女性痤疮患者心理状态与生活质量情况。方法：收集2020年1月至2021年1月就诊于香港大学深圳医院皮肤科门诊的689例女性痤疮患者,调查广泛性焦虑障碍量表（GAD-7）、健康问卷抑郁症状群量表（PHQ-9）及痤疮特异性生活质量（AQOL）的得分情况;并按照年龄分组,评估青春期组及成人组心理状态和生活质量的差异。结果：女性痤疮患者中46.30%的患者有抑郁情绪,47.60%的患者有焦虑情绪,AQOL平均得分为68.90±27.40。两组间焦虑、抑郁比例及AQOL评分比较,差异均无统计学意义（均P>0.05）。结论：痤疮对女性患者心理状态和生活质量产生明显的负面影响,青春期与成人期患者无明显区别。