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1.

BACKGROUND

Acne vulgaris can severely affect social and psychological functioning.

OBJECTIVE

The aim of this study was to investigate the impact of acne vulgaris and its severity on Quality of Life of young adolescents in Greece.

METHODS

We conducted a questionnaire based survey among 1560 adolescent between the ages of 11 and 19 years old and 1531 of these were completed. Adolescents with acne filled all the questions including the Children Dermatology Life Quality Index. Adolescents without acne filled the questions about age, family history of acne, stress and smoking. Data were analyzed with Pearson Chi Square test.

RESULTS

Acne prevalence was 51.2% affecting both sexes equally. Self reported mild acne was present in 71.2% and moderate-severe acne in 28.8% of the study population. The mean age of the study population was 15.77y. The median score of Children Dermatology Life Quality Index was 4.02. The impact of acne on quality of life is associated with the severity of the acne (p<0.0001). Patients with moderate/severe acne experience greater psychosocial and emotional impairment (p<0.0001). Body image is modified proportionally to the severity of acne (p<0.0001). Symptoms and treatment of acne are factors that also influence their quality of life. Girls and boys are equally affected. Stress and heredity are correlated with acne and its severity (p<0.0001). We didn''t find any correlation between smoking and acne.

CONCLUSION

Acne affects Quality of Life of young adolescents in Greece. The impact is proportional to the severity of acne. More severe acne is associated with greater effect on quality of life with implications for self esteem, body image and relationships with others.  相似文献   

2.

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.
  相似文献   

3.

BACKGROUND

Autoimmune bullous dermatoses are complex diseases triggered by autoantibodies action against epidermal antigens or the dermoepidermal junction. Blisters and vesicles that evolve with erosion areas characterize them. Although rare, they present high morbidity, affecting the quality of life of patients.

OBJECTIVES

To assess the magnitude of autoimmune bullous dermatoses on life quality of patients treated in a public university service in countryside of Brazil.

METHODS

This cross-sectional study was based on an inquiry with autoimmune bullous dermatoses patients assisted at outpatient university referral service. Elements related to quality of life were evaluated by the Dermatology Life Quality Index, as well as clinical and demographic data.

RESULTS

The study evaluated 43 patients with pemphigus foliaceus, 32 with pemphigus vulgaris, 6 with bullous pemphigoid and 3 with dermatitis herpetiformis. The average age was 48 ± 16 years and 34 (40%) were female. The median score (p25-p75) of the Dermatology Life Quality Index was 16 (9-19), classified as "severe impairment" of life quality, in which the greater impact was related to symptoms and feelings, daily and leisure activities.

CONCLUSIONS

Autoimmune bullous dermatoses inflict severe impairment of quality of life for patients followed by a public outpatient clinic in the countryside of Brazil.  相似文献   

4.

Background

Photodynamic therapy (PDT) using topical aminolevulinic acid (ALA) has increasingly been used for the treatment of acne vulgaris and several studies have shown its clinical efficacy. However, ALA-PDT needs a relatively long incubation period and is frequently associated with adverse effects. Indole-3-acetic acid (IAA) has been introduced as a new photosensitizer for the treatment of acne in recent study. IAA-PDT requires only a short incubation period and the procedure is relatively painless in contrast to ALA-PDT.

Objective

To investigate the efficacy and safety of IAA- PDT in the treatment of acne.

Methods

Twenty-five patients with facial acne lesions were enrolled in this study. IAA-PDT was performed for five sessions at 1-week intervals (week 0~4). IAA was treated with 15 minute occlusion, and green light was given for 15 minutes. Clinical efficacy was determined by evaluating acne lesion counts, severity grading, and the Dermatology Life Quality Index (DLQI) at week 0, 2, 4, and 5. Sebum secretion and erythema index was measured by Sebumeter and Mexameter, respectively, at baseline and one week after each treatment session (week 1~5). Histopathological examination was performed at baseline and week 5. Adverse effects were recorded throughout the study.

Results

All the patients completed the study. Numbers of both inflammatory and non-inflammatory acne lesions were significantly decreased. Acne severity grade and the DLQI showed significant reduction. Sebum secretion and erythema were also reduced. Histopathological examination showed a reduction in inflammatory reactions. No adverse effects were observed except for transient pruritus in one patient.

Conclusion

PDT using IAA and green light was an effective, simple and safe treatment for acne.  相似文献   

5.
6.

Background

Hand eczema is a disease frequently observed in dermatological practice. This condition has negative emotional, social, and psychological effects due to its impact on daily life and morphological appearance. Due to its considerable effect on the quality of life, this disease can lead to depression. However, not many studies have been performed on the quality of life and depression in hand eczema patients.

Objective

The purpose of this study is to investigate the association between the quality of life, depression, and disease severity in hand eczema patients in South Korea.

Methods

A total of 138 patients with hand eczema participated in this study. The patients'' quality of life was assessed by a self-administered questionnaire using the Dermatology Life Quality Index (DLQI). Data on patients suffering from depression was obtained using the Beck''s Depression Inventory (BDI-II). The disease severity was determined during the clinical examination, according to the Hand Eczema Severity Index (HECSI).

Results

We found positive associations between DLQI and HECSI scores (p<0.05). BDI-II scores had also statistically positive correlations with HECSI scores (p<0.05). DLQI and BDI-II scores both increased with disease severity.

Conclusion

Hand eczema negatively affected the quality of life and mood of patients relative to the disease severity. Therefore, we suggest that quality of life modification and emotional support should be included as a part of treatment for hand eczema.  相似文献   

7.

BACKGROUND

many studies about the psychosocial impact of acne have been reported in international medical literature describing quality of life as a relevant clinical outcome. It is well known that the patient''s perception about the disease may be different from the physician''s evaluation. Therefore, it is important to use validated instruments that turn the patient''s subjective opinion into objective information.

OBJECTIVES

to translate into Brazilian-Portuguese language and to culturally adapt a quality of life questionnaire, the Acne-Specific Quality of Life Questionnaire (Acne-QoL), as well as to evaluate its reliability and validity.

METHODS

measurement properties were assessed: 1) validity: comparison between severity and Acne-QoL domain scores, correlations between acne duration and Acne-QoL domain scores, and correlation between Acne-QoL domain scores and SF-36 components; 2) internal consistency: Cronbach''s α coefficient; 3) test-retest reproducibility: intraclass correlation coefficient and Wilcoxon test.

RESULTS

Eighty subjects with a mean age of 20.5 ± 4.8 years presenting mild (33.8%), moderate (36.2%) and severe (30%) facial acne were enrolled. Acne-QoL domain scores were similar among the different acne severity groups except for role-social domain. Subjects with shorter acne duration presented significant higher scores. Acne-QoL domains showed significant correlations, both between themselves and with SF-36 role-social and mental health components. Internal consistency (0.925-0.952) and test-retest reproducibility were considered acceptable (0.768-0.836).

CONCLUSIONS

the Brazilian-Portuguese version of the Acne-QoL is a reliable and valid satisfactory outcome measure to be used in facial acne studies.  相似文献   

8.

BACKGROUND

Psoriasis is a common, long-term skin disease associated with high levels of psychological distress and a considerable adverse impact on life. The effects of psoriasis, beyond skin affliction, are seldom recognized and often undertreated.

OBJECTIVE

The aim of the study is to evaluate the quality of life, anxiety and depression, self-esteem and loneliness in patients with psoriasis.

METHODS

Eighty-four patients with psoriasis were enrolled in the study. The quality of life, depression and anxiety, loneliness and self-esteem of the patient were assessed using the Dermatology Life Quality Index, Hospital Anxiety and Depression Scale, the UCLA loneliness Scale (UCLA-Version 3) and Rosenberg''s Self-esteem Scale, respectively.

RESULTS

The Dermatology Quality of Life Index score among psoriasis patients was 12.61 ± 4.88. They had statistically significantly higher scores according to the Hospital Anxiety and Depression Scale -anxiety subscale (p=0.032)-compared with healthy volunteers. Moreover, a statistically significant difference was found between the two groups concerning the UCLA-scale (p=0.033) and RSES-scale (p<0.0001). Female patients presented with lower self-esteem than male patients.

CONCLUSION

Psoriasis is a distressing, recurrent disorder that significantly impairs quality of life. Therefore, the recognition and future management of psoriasis may require the involvement of multi-disciplinary teams to manage the physical, psychological and social aspects of the condition, as is the case for systemic, long-term conditions.  相似文献   

9.
Acne vulgaris is a chronic condition affecting more than 85% of adolescents and young adults. It is one of the most common diseases affecting humanity and its impact on quality of life (QoL) is important. The impact of acne on QoL in Indian patients remains undocumented. The study was undertaken to detect the impact of acne vulgaris and related factors that may influence the QoL.

Materials and Methods:

This was a hospital-based, prospective, cross-sectional, prestructured, questionnaire-based study done on 140 consenting individuals, who attended the Dermatology outpatient department. Acne vulgaris was graded using simple grading system. QoL was measured using a combination of skin disease-specific (Dermatological Life Quality Index (DLQI)) and acne-specific (Cardiff Acne Disability Index (CADI)) questionnaires.

Results:

Majority of our study population were students (103, 73.6%). Face (139, 99.3%) was the commonest site of acne and comedones 133, 95% were the commonest type of lesion. Most of the individuals 66, 47.1% were observed to have grade 1 acne. The mean DLQI score was 6.91 and the mean CADI score was 5.2. Association between the scores was statistically significant. Age, occupation, marital status, family, and treatment history played a role in affecting the QoL. Diet, smoking, and alcohol did not influence the QoL.

Conclusion:

Though acne had impact on patient''s QoL, it was less severe in our study. It is important for health professionals to incorporate QoL measurements when managing acne patients to provide better and appropriate care.  相似文献   

10.

BACKGROUND

atopic dermatitis is directly related to psychological stress, reduced quality of life and psychosomatic symptoms. The Psychosomatic Scale for Atopic Dermatitis is the only questionnaire developed specifically for assessment of psychosomatization in atopic dermatitis.

OBJECTIVES

the objective of this study was to cross-culturally adapt and validate a Brazilian-Portuguese version of the Psychosomatic Scale for Atopic Dermatitis.

METHODS

adaptation consisted of independent translation and backtranslation by three bilingual translators, followed by a pre-test. The Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index were self-administered to 47 patients with atopic dermatitis. Disease severity was evaluated using the Eczema Area and Severity Index. Factor analysis was used to identify the dimensions of the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis. Internal consistency and convergence validity were also analyzed. Reproducibility was assessed using the Kappa coefficient.

RESULTS

factor analysis revealed a two-dimensional structure: stress/laziness/insecurity (I) and maladjustment/social relationships (II), explaining 54.4% of total variance. All dimensions revealed excellent internal consistency. External construct validity was confirmed by positive correlations between the Psychosomatic Scale for Atopic Dermatitis and the Dermatology Life Quality Index. Test-retest reliability was excellent, with k>0.7 for all questions.

CONCLUSIONS

the Brazilian Portuguese version of the Psychosomatic Scale for Atopic Dermatitis demonstrated acceptable psychometric properties and can be used for the evaluation of psychosomatic symptoms in patients with atopic dermatitis and as a tool in clinical and epidemiological research.  相似文献   

11.

BACKGROUND

The literature has shown that the presence of emotional disturbances in caregivers of children with skin diseases affects the course and treatment of the disease. Anxiety and depression are among the most frequently reported psychiatric diagnoses related to this fact.

OBJECTIVE

To evaluate the presence of anxiety and depression in caregivers of pediatric patients with chronic skin disorders, exemplified by atopic dermatitis, psoriasis and vitiligo, and correlate them to the quality of life of the patients.

METHODS

The sample consisted of 118 patients with atopic dermatitis, vitiligo and psoriasis, monitored by their main caregiver. The levels of anxiety and depression in the caregivers were assessed using the Hamilton Anxiety Scale and the Beck Depression Inventory, respectively. The Children''s Dermatology Life Quality Index was applied.

RESULTS

Anxiety was observed in 36% of the caregivers of the patients with atopic dermatitis, in 36% of those of children affected by psoriasis, and in 42% of those responsible for pediatric patients with vitiligo. Depression occurred in 36% of the caregivers of patients with atopic dermatitis, in 36% of those of children affected by psoriasis and in 26% of those responsible for pediatric patients with vitiligo. There was a significant correlation between poor quality of life scores in patients with vitiligo and the presence of depression and anxiety in their caregivers.

CONCLUSION

Emotional disorders tend to be present among close family members of children with the chronic skin diseases studied and their prevention can help in controlling and treating these diseases.  相似文献   

12.

Background

Measuring the quality of life (QOL) is important in the evaluation of nonclinical aspects of diseases, for the discovery of functional and psychological limitations, and in choosing treatment in the initial phase of the disease. Pemphigus is a potentially fatal autoimmune bullous disease caused by autoantibodies against desmogleins (cadherin family proteins in desmosomes). Thus far, there has been no published study on QOL in Korean patients with pemphigus.

Objective

To study the impact of pemphigus on the QOL in a large number of Korean patients.

Methods

Sixty-six patients enrolled at the Gangnam Severance Hospital from March 2012 to March 2013 were assessed for QOL by using the Dermatology Life Quality Index (DLQI), and for anxiety and depression by using the General Health Questionnaire (GHQ). Spearman''s rank-order correlation, t-test, and ANOVA were used to identify the relations between the DLQI score and other clinical variables.

Results

Pemphigus vulgaris and pemphigus foliaceus significantly reduced the QOL of patients. The average DLQI score for all patients was 10.18. The mean DLQI score was 13.45 in patients in the active state and 5.15 in the patients in the remission state. The DLQI score highly correlated with disease severity, titer of anti-desmoglein 1 in enzyme-linked immunosorbent assay, and the corticosteroid dose. However, the QOL was not affected by sex, age, subtype of pemphigus, duration of disease, or comorbidities. Forty-two percent of the patients showed a positive result in the GHQ, reflecting probable minor psychiatric nonpsychotic conditions, and the GHQ score positively correlated to the DLQI score.

Conclusion

Pemphigus significantly impairs the QOL of patients. The QOL of Korean pemphigus patients significantly correlates with clinical severity. Therefore, considerable attention should be paid to the patients'' QOL and psychological states as well as clinical status.  相似文献   

13.

Background:

Vitiligo is an acquired discoloration of skin and mucous membrane of great cosmetic importance affecting 1-4% of the world''s population. It causes disfiguration in all races, more so in dark-skinned people because of strong contrast. Men, women, and children with vitiligo face severe psychological and social disadvantage.

Aim:

To assess the impact of the disease on the quality of life of patients suffering from vitiligo, also to ascertain any psychological morbidity like depression associated with the disease and to compare the results with that of healthy control group.

Materials and Methods:

Dermatology Life Quality Index (DLQI) and Hamilton Depression Rating Scale (HAMD) are administered to 100 vitiligo patients presenting to the Dermatology OPD and 50 age- and sex-matched healthy controls. Results were analyzed and compared with that of control group. Findings are also correlated in relation to demographic and clinical profile of the disease. Statistical analysis is made to see the significance.

Results:

Vitiligo-affected patients had significantly elevated total DLQI scores (P < 0.001) compared to healthy controls. There is increase in parameters like itch, embarrassment, social and leisure activities in the patient cohort than the control group. Patients of vitiligo are also found to be more depressed (P < 0.001) than the controls.

Conclusion:

Quality of life (QOL) in patients affected with vitiligo declined more severely, and also there is increase in incidence of depression than in the control group. These changes are critical for the psychosocial life of the affected people.  相似文献   

14.

Background

Pruritus affects the quality of life (QoL) in the patients. However, little is known of the impacts of itching on the QoL in the literature.

Objective

In this study, a questionnaire eliciting specific responses about pruritus was used to determine the effect of itching and its severity on QoL in chronic pruritic patients.

Methods

One hundred ten adult patients with chronic pruritus were surveyed. Once itch severity had been self-reported by patients, together with Skindex-29, they have been given the 18-item Pruritus-related Life Quality Index (PLQI) questionnaire, which was used to generated the new index.

Results

Significant correlations have been found between the pruritus severity score of participants and their total Skindex-29 (p<0.001) with its function, emotion and symptom subscale scores (p<0.001 for each). Also, significant correlations were evident between total PLQI (p<0.001) and its psychosocial negativities, difficulties in everyday activities and social live subscale scores (p<0.001 for each). In particular, the emotion subscale of Skindex-29 (p=0.02) and psychosocial negativity subscale of PLQI (p=0.02) were significantly high in psychopathologic patients. A highly positive statistical correlation between Skindex-29 and PLQI scales was evident (r=0.845, p<0.001). For reliability, Cronbach''s coefficient a coefficients were 0.931 for the Skindex-29 scale and 0.918 for the PLQI scale.

Conclusion

The results demonstrate that chronic pruritus appreciably reduces the QoL. PLQI could be used in the development of new questionnaires for determining the QoL of patients with chronic itch.  相似文献   

15.

Background

We believe that instances of neuroticism and common psychiatric disorders are higher in adults with acne vulgaris than the normal population.

Objective

Instances of acne in adults have been increasing in frequency in recent years. The aim of this study was to investigate personality traits and common psychiatric conditions in patients with adult acne vulgaris.

Methods

Patients who visited the dermatology outpatient clinic at Bozok University Medical School with a complaint of acne and who volunteered for this study were included. The Symptom Checklist 90-Revised (SCL 90-R) Global Symptom Index (GSI), somatization, depression, and anxiety subscales and the Eysenck Personality Questionnaire-Revised Short Form (EPQ-RSF) were administered to 40 patients who fulfilled the inclusion criteria before treatment. The results were compared with those of a control group.

Results

Of the 40 patients included in this study, 34 were female and 6 were male. The GSI and the somatization, depression, and anxiety subscales of the SCL 90-R were evaluated. Patients with adult acne had statistically significant higher scores than the control group on all of these subscales. In addition, patients with adult acne had statistically significantly higher scores on the neuroticism subscale of the EPQ-RSF.

Conclusion

Our results show that common psychiatric conditions are frequent in adult patients with acne. More importantly, neurotic personality characteristics are observed more frequently in these patients. These findings suggest that acne in adults is a disorder that has both medical and psychosomatic characteristics and requires a multi-disciplinary approach.  相似文献   

16.
17.

BACKGROUND

Acne vulgaris has high prevalence, disturbing quality of life during adolescence.

OBJECTIVES

To measure dissastifaction and acne in 18-year-old male individuals and its associated factors.

METHODS

A questionnaire was applied by trained interviewers to all boys during selection for the military service. Dissatisfaction and acne was evaluated using a self-administered face scale. Facial, prestrernal and dorsal acne were evaluated separately.

RESULTS

A total of 2,200 adolescents, aged 18 years, were interviewed. Among these, 1,678 had acne on the face and 974 (54.05%) showed some degree of dissatisfaction. Regarding the impact of acne located on the chest, 326 out of 686 adolescents (47.52%) reported dissatisfaction. For acne located on the back, 568 out of 1,103 affected individuals (51.50%) showed dissatisfaction. Facial / dorsal acne and dissatisfaction were statistically associated with lower income, lower education levels and with non-whites. Presternal acne and dissatisfaction were statistically asssociated with lower income and lower education levels.

CONCLUSION

This population-based study found a high prevalence of acne on the face, back and chest, with high rates of dissatisfaction.  相似文献   

18.

Background

Acne vulgaris is the most common skin disease worldwide, with many available treatment modalities, including oral and topical medications and laser therapy. Recently, a novel device (Isolaz, Pleasanton, CA, USA) that combines vacuum pressure and a broadband light source (400 nm to 1,200 nm) was developed for the treatment of acne.

Objective

To determine the clinical efficacy and safety of photopneumatic therapy for the treatment of acne vulgaris of the face.

Methods

Twenty adults with mild to moderate facial acne vulgaris received 4 successive treatments on one side of the face with a combined photopneumatic device (intense pulsed light: fluence=5.8 J/cm2; negative pressure=iMP mode) at 2 week intervals. Acne lesions on the opposite side of the face were not treated. Lesion counts were performed at baseline, prior to each treatment session, and at 3 months after the final treatment session.

Results

Significant lesion improvements and reduced numbers of acne lesions were observed on the treated side of the faces. Most patients experienced global clinical improvement. No severe side effects occurred during the study, with only a few patients experiencing transient erythema, purpura and/or exacerbation of pre-existing acne.

Conclusion

Photopneumatic therapy is a safe and effective treatment for mild to moderate acne vulgaris.  相似文献   

19.

Background:

The psychological impacts of acne appearance and its-related negative emotional reactions have been proved; however, these reactions are varied in different populations.

Aim:

We investigated whether acne and its severity affected psychological functioning in those who suffered from this disorder among Iranians.

Materials and Methods:

One hundred and six patients with acne vulgaris who consecutively attended the dermatology outpatient clinics in Semnan city in 2008 were included. Among them, 103 patients met the study''s inclusion criterion and agreed to participate. One hundred and six age and gender cross-matched healthy volunteers were included as controls that attended the clinic with their diseased relatives. All acne patients were evaluated using the Symptom Check List-90 (SCL-90).

Results:

According to the American Academy of Dermatology classification, 25.2% of the patients had mild acne, 50.5% moderate acne, and 24.3% severe acne. A higher percentage of participants than controls required further evaluation and psychological consultant when studying each psychological problem. The most common psychological symptoms requiring treatment due to disturbed daily activities in acne group were psychoticism (34.0%) and depression (31.1%), respectively. Significant positive correlations were observed between the duration of illness and SCL-90 total score. When evaluating the SCL-90 scores, patients with multiple sites of involvement were affected more severely than those with a single site of involvement.

Conclusion:

Acne vulgaris has significant effects on psychological status. Effective concomitant anti-acne therapy and psychological assessment make significant contributions for the mental health and should be strongly recommended.  相似文献   

20.

BACKGROUND

Acne vulgaris has an important genetic predisposition, as well as keratosis pilaris. Clinical observations suggest that patients with keratosis pilaris have less frequent or less severe acne breakouts; however, we found no studies on this regard

OBJECTIVE

To determine if the presence of keratosis pilaris is associated with lower prevalence and severity of acne.

METHODS

A cross-sectional study was conducted with dermatology outpatients aged between 14 and 35 years. We evaluated history and clinical grade of acne, demographic variables, history of atopy, smoking, and use of hormonal contraceptives. Two groups were defined by the presence or absence of moderate to severe keratosis pilaris on the arms and were compared by bivariate analysis and by conditional multiple logistic regression.

RESULTS

We included 158 patients (66% women), with a median age of 23±11 years. Twenty-six percent of them had keratosis pilaris, which was associated with a history of atopy (odds ratio [OR]=2.80 [1.36 to 5.75]; p<0.01). Acne was present in 66% of subjects, and was related to family history of acne (OR=5.75 [2.47 to 13.37]; p<0.01). In bivariate and multivariate analysis, the group with keratosis pilaris had a less frequent history of acne (OR=0.32 [0.14 to 0.70]; p<0.01).

CONCLUSION

The presence of moderate to severe keratosis pilaris on the arms was associated with lower prevalence of acne vulgaris and lower severity of facial lesions in adolescents and young adults.  相似文献   

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