Temperament and character profile of patients with psoriasis

Background Psychosocial factors have been implicated as being important in the onset and/or exacerbation of psoriasis.¹ The aim of this study is to examine both the personality factors of patients with psoriasis and the correlations between temperament and character dimensions. Material and methods A total number of 105 psoriasis patients and 109 healthy individuals were enrolled in the study. Questionnaires including Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), and Temperament and Character Inventory (TCI) were administered individually. Both groups were evaluated in terms of depression, anxiety and characteristic features by using these psychological tests and compared statistically. The relationship between psoriasis area and severity index (PASI) score and the BDI, BAI and TCI scales were also evaluated. Results The mean BDI score of the psoriasis group were significantly higher than the control group. The psoriasis group had significantly higher scores of harm avoidance and lower scores of being self‐directedness than the control group. The duration of psoriasis and the PASI scores were not correlated with BDI and BAI scores. Conclusion The current study shows that psoriasis patients have distinctive temperament and character dimensions when compared with the control group. We suggest that evaluation and treatment of psoriasis should also include psychosomatic approaches in clinical practice.     

The impact of rosacea on quality of life: effects of demographic and clinical characteristics and various treatment modalities

Summary Background Rosacea has a major psychosocial impact on a patient’s life. Objectives To determine the impact of rosacea on patient quality of life, the relationship of quality of life scores to clinical and demographic variables, and the change in quality of life following various treatments. Methods Patients’ demographic and clinical characteristics were recorded at their initial examination and their response to treatment and side‐effects were recorded additionally at their follow‐up examination. Rosacea severity was scored for each of four signs from 0 to 3. Patients were requested to complete Dermatology Life Quality Index (DLQI) questionnaires. Results A total of 308 patients took part in this study. Mean ± SD DLQI total score at the initial visit was 6·93 ± 5·18 and was related to patients’ age, sex, age at disease onset, subjective symptoms, triggering factors, previous treatments, rosacea severity scores and patients’ self‐assessment of ease of living with rosacea. Of these 308 patients, 164 completed the DLQI following treatment. Mean ± SD post‐treatment DLQI score was 4·36 ± 4·82. Post‐treatment scores were also related to sex, type of treatment modality, development of side‐effects, improvement of rosacea, rosacea severity scores and patients’ self‐reported ease of living with rosacea. Topical metronidazole, oral tetracycline and oral isotretinoin were observed to reduce signs and symptoms of rosacea and DLQI scores significantly at this repeat examination. Conclusions Rosacea affects patients’ lives to a moderate extent, and this can be assessed by using DLQI. DLQI is also sensitive to quality of life changes brought about by treatment of rosacea. As a preliminary result we can say that topical metronidazole, oral tetracycline and oral isotretinoin seem to improve quality of life of patients by improving lesions of rosacea more efficiently than other therapeutic agents.     

Psychiatric comorbidities in patients with alopecia areata in Taiwan: a case-control study

Background Alopecia areata (AA) may be related to stress and has been reported to be associated with psychiatric disorders. Nevertheless, a nationwide study of the relationship between AA and comorbid psychiatric diseases has not been conducted, and the effect of onset age has rarely been reported. Objectives To analyse the associations between AA and various psychiatric disorders using a nationwide database in Taiwan. Methods Data were obtained from the National Health Insurance Research Database of Taiwan from 2000 to 2009. In total, 5117 patients with AA and 20 468 age‐ and gender‐matched controls were enrolled. Results Patients with AA tended to have more coexisting anxiety and less comorbid schizophrenia. Differences in ages of onset revealed differences in comorbidities. An increased risk of depression [odds ratio (OR) 2·23; 95% confidence interval (CI) 1·09–4·54] was found in patients with AA aged < 20 years. An increased rate of anxiety (OR 1·43; CI 1·15–1·77) was observed with AA onset between the ages of 20 and 39 years. The highest odds of obsessive–compulsive disorder (OR 3·00; CI 1·11–8·12) and anxiety (OR 2·05; CI 1·56–2·68) were observed in patients with AA aged 40–59 years. Moreover, about 50% of psychiatric disorders occurred earlier than AA. Conclusions AA is related to various psychiatric disorders. Onset age of AA is an important factor in the association with different comorbid psychiatric diseases. In addition to cosmetic impact, which may bring about anxiety or depression, stress neuroendocrine immunology may play an important role in the pathogenesis of both AA and psychiatric disorders.     

Mental health in patients with pemphigus: an issue to worth consideration

Background:

There exists a high prevalence of psychiatric disorders in dermatological patients. Although, investigators have evaluated psychiatric aspects of the patients suffering from skin diseases; there are rare studies concerning mental health in pemphigus patients. The objective of this study was to evaluate mental health status and quality of life of newly diagnosed pemphigus patients.

Materials and Methods:

Between April 2007 and June 2008, all newly diagnosed pemphigus patients attending the outpatient clinic of a dermatological hospital were given a questionnaire comprising the GHQ-28 and DLQI to fill out.

Results:

Of 283 patients, 212 complete forms were returned. The bimodal score of GHQ ranged from 0 to 26 (Mean = 9.4) and the Likert score of GHQ ranged from 6 to 68 (Mean = 31.9). The DLQI score ranged between 0 and 30 (Mean of 13.8). A total of 157 patients (73.7%) were yielded to be possible cases of mental disorder considering GHQ-28 bimodal scores. Significant correlation was detected between the DLQI score and bimodal and Likert scoring of GHQ-28.

Conclusion:

Our study has depicted high prevalence of psychiatric comorbidity in pemphigus patients. It underlines the fact that physicians, who are in-charge of care for these patients, are in an exceptional position to distinguish the psychiatric comorbidity and to take appropriate measures.     

Temperament and character dimensions in patients with atopic dermatitis

The aim of this study was to assess the personality traits of young male patients with atopic dermatitis (AD), and to examine the correlations between temperament and character dimensions with clinical and other psychological factors. Fifty young adult male AD patients and 83 healthy controls were examined using the temperament and character inventory, the Beck depression inventory and the state-trait anxiety inventory. The AD patients scored higher on harm avoidance and lower on reward dependence, self-directedness and cooperativeness than the healthy controls. The illness duration and anxiety correlated negatively with the self-directedness score, and depression correlated negatively with reward dependence and the persistence scores in AD patients. These results suggest that AD patients have distinctive temperament and character dimensions compared to healthy controls. Moreover, illness duration and anxiety might be associated with some personality problems, and some temperament dimensions (e.g. reward dependence, persistence) may be linked to depressive symptoms in AD patients.     

Temperament and character profile in patients with essential hyperhidrosis

BACKGROUND/AIMS: The main debates on hyperhidrosis are whether there are some personality features such as anxiety or stress, or whether the psychological symptoms are due to negative social feedback from early life. We aimed to investigate the temperament and character dimensions with a psychobiological inventory. METHODS: We recruited patients with hyperhidrosis (n=26) and chronic renal failure (n=44) as well as healthy subjects (n=22) from dermatology and nephrology clinics and the general population in Afyonkarahisar. All subjects were required to perform a temperament and character inventory. RESULTS: The total novelty seeking score in hyperhidrosis was significantly lower than in controls. There was no significance in total harm avoidance scores between hyperhidrosis patients and controls. The total reward dependence and persistence scores were significantly higher in hyperhidrosis patients. The fear of uncertainty in the harm avoidance scale was found to be significantly greater in hyperhidrosis patients. Regarding character dimensions, the total score in each of the subscales self-directedness, cooperativeness and self-transcendence was found to be higher in hyperhidrosis patients. CONCLUSION: The higher scores of all subscales of character dimensions in hyperhidrosis patients suggest that hyperhidrosis is not related with social phobia or personality disorder.     

Correlating the Dermatology Life Quality Index with psychiatric measures: A systematic review

Skin conditions may have a major impact on the psychologic well-being of patients, ranging from depression to anxiety. The Dermatology Life Quality Index (DLQI) is the most commonly used quality of life tool in dermatology, though it has yet to be correlated with psychiatric measures used in clinical therapeutic trials. We conducted a systematic review to determine whether there is any correlation between the DLQI and psychiatric measure scores, potentially allowing the DLQI to be used as a surrogate measure for depression or psychiatric screening. Six databases were searched using the following keywords: “DLQI,” “Dermatology Life Quality Index,” “Psych*,” “depression,” “anxiety,” “stress,” and “trial*.” All randomized trials where full DLQI and psychiatric scores were provided were included. PRISMA guidelines were followed. In all, 462 records were screened, but only seven met inclusion criteria. Hospital Anxiety and Depression Scale (HADS) was the most commonly used psychiatric measure; the “depression” component score changes correlated strongly with the DLQI (r = 0.715). There needs to be guidance on psychiatric measurement and reporting in clinical trials. Although the DLQI correlated well with the “depression” domain of the HADS scale, interviews and screening for depression are still vital for full assessment of patient psychologic well-being.     

There is no correlation between acne severity and AQOLS/DLQI scores

The prevalence of psychiatric disorders is quite high in dermatological diseases. Psychiatric problems are also seen in acne, which involves young people in particular. In this study, carried out to evaluate the effect of acne on the quality of the social, school and private lives of university students, a total of 19 questions contained in AQOLS (Acne Quality of Life Scale) and DLQI (Dermatology Life Quality Index) were asked of the acne patients and healthy controls. The statistically significant relationships between the acne severity and AQOLS/DLQI as well as any possible differences between the AQOLS and DLQI scores in acne patients and healthy controls were investigated. Mann-Whitney U, Kruskal-Wallis and Spearman correlation tests were used in statistical analyses. For reliability, Cronbach-a analysis was used. The ages of 108 patients, 67 females (62%) and 41 males (38%), ranged between 16 and 29 (20.43+/-1.92). The ages of 100 controls, 61 females (61%) and 39 males (39%), ranged between 18 and 24 (19.45 +/- 1.35). There were no significant relationships between acne severity and AQOLS/DLQI (p=0.767). No statistically significant correlation was found between the acne patients with scars and those without scars with respect to AQOLS (p=0.253) and DLQI (p=0.255) scores. Statistically, AQOLS (p=0.000) and DLQI (p=0.000) scores of the patients with acne were found to be significantly higher as compared to the control groups. Consequently, it has been found in our study that the life quality of acne patients can be affected by reasons other than acne severity and presence of scars. The reasons can be social, personal, emotional and school-related problems of the patients. For that reason, life quality of patients should be evaluated with psychiatric measurements other than AQOLS and DLQI. In conclusion, these scores are not good enough to evaluate acne patients's quality of life.     

Psychosomatic aspects of alopecia areata

Psychologic and social effects of scalp hair are more important than its biologic significance. Etiology of alopecia areata (AA) suggests a predominantly autoimmune reaction. Correlation between AA and psychologic disorders is reciprocal. Psychiatric disorders can trigger the onset of AA and its negative consequences may develop or exacerbate psychologic problems. The high incidence of a neurotic personality, depression, anxiety, and deficiency in coping with stress strengthen the role of psychic factors in the pathogenesis of AA.Strategies to assess these patients are often not apparent for the clinician and identifying patients in need of extra psychologic support should be a mainstay for successful treatment. Women, young patients, and those with significant AA or previous psychiatric disorders are at greater risk, requiring careful monitoring. Proper awareness and consciousness about the close relationship between AA and psychologic factors are essential.     

Quality of life in alopecia areata: a disease‐specific questionnaire

Background Alopecia areata (AA) is an autoimmune disease affecting about 2% of the population, which has a considerable impact on quality of life (QoL). There are no disease‐specific questionnaires to assess QoL in patients suffering from AA. Objective To validate a new disease‐specific questionnaire for AA, named AA‐QLI, and to compare the consequent Quality of Life Index (QLI) with the commonly known Dermatology Life Quality Index (DLQI) to verify if it can provide a more comprehensive tool for patients. Methods A total of 50 patients affected by AA were administered both the AA‐QLI, created by us, and the well‐known DLQI. With the aim to detect suitable QLI, we propose to use two multivariate analyses:

• ? a principal component analysis approach on the data collected with both questionnaires to compare their capability to measure the QoL;
• ? a structural equation modelling on our AA‐QLI to identify which category of symptoms mostly affects the QoL.

Results The scores of both the questionnaires are quite close, except for a few cases. Statistical analysis shows a higher specificity of the AA‐QLI for evaluating QoL. Among the three areas in which AA‐QLI is divided, ‘Relationship’ has a major impact on the QLI, followed by ‘Subjective symptoms’; ‘Objective signs’ has a lower weight on the QLI. Conclusion AA‐QLI is a good instrument to evaluate the real impact of AA on QoL. It can be helpful both for the physician and for the patient.     

Quality of life and stigmatization profile in a cohort of vitiligo patients and effect of the use of camouflage

BACKGROUND: Few studies have paid attention to the effects of treatment interventions on the psychosocial consequences of vitiligo. OBJECTIVES: To quantify and analyse the psychosocial benefit of the use of camouflage in vitiligo patients. PATIENTS AND METHODS: 78 vitiligo patients completed the Dermatology Life Quality Index (DLQI) and an adapted stigmatization questionnaire, and 62 of them completed the DLQI after at least a 1-month use of camouflage. RESULTS: The initial mean overall DLQI score (n = 78) is 6.9 (SD 5.6). The mean global stigmatization score is 38%. Disease extent and disease severity are strong predictors of the DLQI (p < 0.0001). Vitiligo on the face/head/neck substantially affects the DLQI, independently of degree of involvement. The mean DLQI score before and after use of camouflage (n = 62) is 7.3 (SD 5.6) and 5.9 (SD 5.2; p = 0.006). Mainly the high-scoring items 'feelings of embarrassment and self consciousness' and 'choice of clothing' improve. Predictors of improvement are higher DLQI scores (p = 0.0005) and higher total severity scores (p = 0.03). CONCLUSIONS: Camouflage can be recommended, particularly in patients with higher DLQI scores or self-assessed disease severity. Patients with minor involvement of the face benefit from camouflage.     

Clear or almost clear skin improves the quality of life in patients with moderate‐to‐severe psoriasis: a systematic review and meta‐analysis

Psoriasis Area and Severity Index (PASI) 75 response is currently considered the gold standard for assessing treatment efficacy in moderate‐to‐severe psoriatic patients. PASI 90 response denotes better clinical improvement compared to PASI 75. Very few studies have assessed if a greater PASI clinical response is associated with greater improvements in Dermatology Life Quality Index (DLQI). A systematic review and meta‐analysis was performed to assess the association between PASI response and DLQI. The study was conducted to assess whether greater improvement in PASI scores from PASI 75–89 to PASI 90 is associated with greater Quality of life (QoL) improvements, specifically DLQI scores. Systematic searches were conducted in MEDLINE, EMBASE and Cochrane Library to identify studies evaluating biologic interventions in adult moderate‐to‐severe psoriasis patients reporting PASI response and their corresponding DLQI change from baseline score. The quality of evidence was assessed through Jadad score for randomized controlled trials and Downs and Black's checklist for observational studies. Meta‐analysis estimated change from baseline in DLQI for PASI 75–89 responders to be 78% (95% credible intervals [CrI]: 75–82%) and for PASI 90 responders to be 90% (95% CrI: 88–93%). This implies 12% greater improvement in DLQI score for PASI 90 responders compared with PASI 75–89 responders. In addition, the meta‐analysis also showed a statistically significant difference in DLQI score of 0/1 between PASI 75‐89 and PASI 90 responders (45% [95% Crl]; 41.0–50.0% and 73% [95% Crl]; 70.0–76.0%), respectively, Bayesian P < 0.0001). In conclusion, substantial improvement in clinical efficacy is associated with improved QoL in patients with moderate‐to‐severe psoriasis suggesting that PASI 90 responders (clear or almost clear skin) could achieve a superior QoL compared to PASI 75–89 responders.     

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.     

Salivary chromogranin A levels correlate with disease severity but do not reflect anxiety or personality of adult patients with atopic dermatitis

Stress‐induced scratching is an issue in patients with adult atopic dermatitis (AD). Although itching and stress are believed to be intimately related, no objective index is available; therefore, most evaluations are subjective. Using saliva, which is easily collected, we investigated the degree to which AD severity and patient stress levels are reflected in stress proteins in the saliva. Here, we evaluated the severity (Scoring Atopic Dermatitis [SCORAD] score), stress (State–Trait Anxiety Index [STAI] score), personality (Tokyo University Egogram [TEG] II score) and quality of life (Dermatology Life Quality Index [DLQI] score) of 51 patients with AD who were examined in the Department of Dermatology of Shimane University between April and December 2015. We collected saliva and measured salivary chromogranin A (CgA), amylase and cortisol. The amount of salivary CgA per protein in patients with AD was correlated with their SCORAD score (r = 0.458, P < 0.001). There was no correlation between cortisol or amylase levels and SCORAD score. SCORAD score was correlated with DLQI (r = 0.390, P = 0.006). CgA per protein was correlated with DLQI (r = 0.393, P = 0.004). There was no correlation between scores for the anxiety component of the STAI, TEG II or DLQI. Our results suggested that patients with more severe AD may have high stress levels. The personalities of these patients with AD tended to involve elevated anxiety levels.     

Health‐related quality of life among Darier’s disease patients

Background Darier’s disease (DD) is an autosomal dominant skin disorder characterized by persistent eruption of hyperkeratotic papules. The effect of DD on quality of life (QOL) has been assessed in only one study, which found no correlation between the Dermatology Life Quality Index (DLQI) score and clinical severity of the disease. The correlation between health‐related quality of life (HRQL) and other diseases and patient characteristics has not been studied. Objectives To examine the HRQL of patients with DD and to evaluate the association between HRQL scores and disease and patient characteristics. Methods A total of 74 DD patients completed three QOL questionnaires: DLQI, EQ‐5D, and one specially designed for the study. The data reported in this study were collected as part of a larger study on the clinical characteristics of DD; the socio‐demographic and clinical data were used in the statistical analysis of the current study. Results Mean DLQI was 5.41 ± 5.57 and the mean EQ‐Visual Analogue Scale (VAS), was 70.84 ± 19.25. DLQI and EQ‐VAS were significantly associated with skin area affected, disease severity, age at onset of DD and a seborrhoeic distribution pattern of DD. Stepwise linear regression showed skin area affected to be the most significant variable in the predication of DLQI (beta = 0.183; SE = 0.04; P < 0.001), and disease severity the most significant variable in the predication of EQ‐VAS (beta = ?9.15; SE = 3.21; P < 0.006). Conclusions Darier’s disease has a negative impact on HRQL of patients and the HRQL is associated with various disease characteristics, mainly skin area affected and clinical severity.     

瘢痕疙瘩患者128例生活质量评估及影响因素分析

目的 评估瘢痕疙瘩对患者生活质量的影响,并分析其影响因素.方法 应用皮肤病生活质量指数(dermatology life quality index,DLQI)评估瘢痕疙瘩患者的生活质量.结果 共调查了128例瘢痕疙瘩患者,DLQI得分为0～23分,平均为(7.12±4.68)分,患者瘢痕评估量表(patient sc...     

Occupational contact dermatitis has an appreciable impact on quality of life

In this study, we examined the impact of occupational contact dermatitis on quality of life. 181 patients, diagnosed with occupational contact dermatitis over a period of 3 years (1996–1999 inclusive), were sent a questionnaire based on the Dermatology Life Quality Index (DLQI) and the Short Form‐36 (SF‐36). 60 (32%) patients were in industrial occupations and 27 (14%) in health care. An overall response rate of 39% (n=70) was obtained. The median DLQI score was 5, with a mean score 6.6 (SD 6.4), which is similar to that seen in Behçet’s syndrome and urticaria. There was no statistically‐significant difference between male and female median scores (p=0.98) and no significant correlation between age and DLQI score nor between DLQI score and time from diagnosis. The most problematic quality of life areas were symptoms and feelings. Males scored highest in problems associated with work, relationships and treatment, whereas females scored highest in problems associated with symptoms and feelings, daily activities and leisure. The SF‐36 scores showed an association between physical problems and emotional problems affecting work. From this study, it can be seen that occupational contact dermatitis has an appreciable impact on quality of life.     

Measuring disease activity and damage in discoid lupus erythematosus

Background Discoid lupus erythematosus (DLE) is a disfiguring inflammatory skin disease. There is no specific tool for measuring disease severity. Objectives To determine the features needed in a score measuring activity and damage in DLE and to investigate the score’s reliability and its correlation with the physician’s global assessment of disease severity and the patient‐reported Dermatology Quality of Life Index (DLQI). Methods The content of the score was determined following a peer review, pilot work in patients and a preliminary inter‐rater reliability study. The Score of Activity and Damage in DLE (SADDLE) measures severity of activity (erythema, scale, induration) and damage (scarring/atrophy and dyspigmentation) attributable to DLE. Summed scores range between 0 and 195. Inter‐ and intrarater reliability of the score was tested using six assessors and nine patients with DLE. Intraclass correlation coefficients (ICCs) > 0·7 were considered evidence of good inter‐ and intrarater agreement. Results The mean ± SD SADDLE score of nine patients in the inter‐rater reliability study was 47 ± 22 (range 14–102). There was good inter‐rater agreement for the total score [ICC 0·82; 95% confidence interval (CI) 0·61–0·95] and for the activity and damage scales, the individual physical signs and the total scores at individual body sites. The total score demonstrated excellent intrarater reliability (ICC 0·98; 95% CI 0·86–1·00). Although there was poor inter‐rater agreement for global assessments (ICC 0·28; 95% CI 0·06–0·66), a good correlation was demonstrated between total scores and global assessments (r = 0·7). A weaker positive correlation was observed between disease activity scores and DLQI (r = 0·4). Conclusions The SADDLE measures activity and damage in patients with DLE. It demonstrates good inter‐ and excellent intrarater agreement, over and above that for global assessment. It correlates well with global assessment scores. Further studies are required to investigate SADDLE’s responsiveness to change with therapy.     

Comorbidity of psychiatric disorders in children and adolescents with alopecia areata in a child and adolescent psychiatry clinical sample

Background This study reports the comorbidity of lifetime psychiatric disorders in children and adolescents with alopecia areata (AA) in a child and adolescent psychiatry clinical sample. Methods Fourteen patients with AA were interviewed using the Diagnostic and Statistical Manual of Mental Disorders‐Fourth edition (DSM‐IV) criteria and the Kiddie‐Schedule for Affective Disorders and Schizophrenia‐Present and Lifetime‐Farsi Version (KSADS‐PL‐Farsi Version). Results The rate of at least one psychiatric disorder was 78%. The rate of major depressive disorder was 50%, and the most common anxiety disorder was obsessive–compulsive disorder (OCD) (35.7%). Conclusions There is a very high rate of psychiatric disorders in children and adolescents with AA. This high rate of OCD has not been reported previously. There seems to be a clinical association between OCD and AA in children and adolescents.     

DLQI scores in patients with keloids and hypertrophic scars: a prospective case control study

Background: Keloids and hypertrophic scars (HTS) can cause functional impairment and psychosocial burdens, both of which affects quality of life (QoL). Our aim was to compare Dermatology Life Quality Index (DLQI) scores in patients with keloids and HTS to those of psoriasis patients and normal controls. Patients and Methods: Forty‐eight consecutive patients with keloids and HTS and 48 with psoriasis vulgaris attending our dermatology outpatient clinic, as well as 48 sex‐ and age‐matched healthy controls completed the DLQI. Results: Total DLQI scores of patients with keloids and HTS (7.79 ± 5.10) and psoriasis (8.73 ± 5.63) were comparable and significantly higher than that of healthy controls (0.58 ± 0.77). No significant difference were found between patients with psoriasis and patients with keloids and HTS in terms of the total DLQI scores and the subscale scores (p > 0.05) except “treatment” (p < 0.05) sub‐scale scores which were higher in psoriasis. Conclusions: The QoL of patients with keloids and HTS is impaired as much as that of those with psoriasis. The DLQI questionnaire is a reliable and valid instrument for assessing the QoL in patients with keloids and HTS.