Validation of the Turkish version of the Urticaria Control Test: Correlation with other tools and comparison between spontaneous and inducible chronic urticaria
Emek KocatürkUtkan KızıltaçPelin Kuteyla CanRabia Öztaş KaraTeoman ErdemKübra KızıltaçNagihan SahillioğluAslı GelincikMarcus MaurerKarsten Weller
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アトピー性皮膚炎患者(AD)に対し, 外用療法と塩酸セチリジン内服を併用した場合の症状改善効果および患者評価によるそう痒およびquality of life(QOL)に対する影響をアトピー性皮膚炎重症度スコア, Visual Analogue Scale(VAS)およびDermatology Life Quality Index(DLQI)-base QOL質問票を用いて検討した。対象はAD患者19例(男性7例, 女性12例, 平均年齢28.4±13.6歳)で, 外用療法に加え塩酸セチリジン10mg/day を4週間投与した。軽度改善以上の改善率は2週後で50％, 4週後で80％であり, 中等度以上の改善率は2週後で16.7％, 4週後においては33.3％であった。患者評価によるそう痒のVASスコアおよびDLQI-base QOLスコアも経時的に有意な改善が認められた。これらの結果から, 外用薬と塩酸セチリジンを併用したことでADが改善され, 患者QOLに良好な影響をおよぼしたと考えた。
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There is no standard for assessing pediatric chronic urticaria in Japan. UAS7, weekly total values of the Urticaria Activity Score (UAS), has correlation with Dermatology Life Quality Index (DLQI) which assesses Quality of Life (QOL). The current European Academy of Allergy and Clinical Immunology (EAACI) guidelines recommend assessing disease activity in chronic urticaria by using UAS. We translated UAS into Japanese version, and evaluated usefulness of UAS by comparing with QOL score.Subjects were 42 patients who had received treatments in our clinic from February to September in 2014. They wrote UAS at home. They wrote Children's Dermatology Life Quality Index (CDLQI) when they visited hospital. We assessed correlation UAS7 with CDLQI.Male/Female ratio was 1:1. Median age was 7.5 years old. Duration of chronic urticaria was 5.5 months. Anti-histamine was used in 75%. UAS7 values reflected chronic urticaria patients' quality of life impairment. Change in UAS7 values reflected change in chronic urticaria patients' quality of life impairment.UAS may be a useful tool for assessing QOL in pediatric patients with chronic urticaria.
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Chronic hand eczema (CHE) is a common disease that has a major impact on patients' health and on society.The purpose of this observational, open-label study was to assess the efficacy of treatment with 30 mg/d of oral alitretinoin on the quality of life (QoL) in a group of patients affected by CHE.This study included 15 patients, all suffering from severe CHE refractory to treatment with potent topical corticosteroids, who underwent treatment with 30 mg/d of alitretinoin for a period of 3 months. At the 1- and 3-month points, together with a clinical evaluation, the QoL of these patients were evaluated by the Dermatology Life Quality Index and visual analog scale (EQ5D-VAS).The oral administration of alitretinoin led to a notable QoL improvement among the patients, as shown by the statistically significant improvement in the Dermatology Life Quality Index and in the EQ5D-VAS after 1 and 3 months of therapy.
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Hand dermatitis (HD) is inflammation of the skin of the hands. It ranges in severity and has a significant impact on quality of life (QoL). The physical and psychosocial burden of the disease is comparable with psoriasis in impairment of the QoL of the patient and depression. Quality of life correlates with disease severity.To evaluate the management outcome of HD with a disease severity tool by the physician and quality of life index.This was a cross-sectional study of a cohort of patients with HD over 24 weeks in the dermatology clinic of a tertiary hospital in Nigeria. Disease severity and quality of life were measured using the physician global assessment (PGA) and dermatology life quality index (DLQI), respectively. These were re-administered 6 weeks after treatment. Results were collated and analyzed.One hundred and seventy-seven (13.3%) of 1,329 patients had HD with F/M ratio of 1.2: 1; a mean age of 34.6 ± 7.4 years. Comparing PGA scores at baseline and 6 weeks, a statistically significant improvement was noted P < 0.001. The mean DLQI score at baseline was 10.38 and reduced to 3.02 post-treatment. The difference between the two means of the DLQI was ≥5 from baseline signifying improved quality of life. The domain of symptoms and feelings was the most affected at baseline and most improved afterward.HD has a significant impact on its sufferers and this correlates with disease severity. Appropriate management improves disease outcome and patients' quality of life.
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Omalizumab is a third-line treatment for chronic spontaneous urticaria (CSU). However, the real-life data on the impact of omalizumab on CSU-related quality of life (QoL) remain scarce.To investigate the impact of omalizumab on QoL and its predictors in CSU. A retrospective cohort study was done. The response to therapy was evaluated using urticaria activity score over 7 days (UAS7) and urticaria control test (UCT); the impairment in QoL was assessed using dermatology life quality index (DLQI) and chronic urticaria quality of life questionnaire (CU-Q2oL).Forty-two patients were included. All scores improved from baseline to first month and remained stable at the third month of treatment (p < .001). The gender, age, and angioedema had no significant effect on QoL, but the complete responders (UAS7:0-1) had better improvement rates in all scores compared to others. The baseline UAS7, DLQI, and CU-Q2oL scores were lower at the baseline in complete responders (p = .0001).A rapid and continual improvement in QoL was obtained with omalizumab treatment. A better UAS7, UCT, DLQI, and CU-Q2oL score at the baseline might be a predictor of a better response to omalizumab and more improvement in QoL.
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Chronic urticaria (CU) is characterized by the presence of wheals and pruritus in the majority of days for more than six weeks, affecting quality of life as in patients with ischemic cardiopathy. There is a validated specific instrument in Spanish to assess quality of life in chronic urticaria (CU-Q2oL).To show the association between severity of CU and quality of life in patients according to urticaria activity score (UAS) and questionnaire of quality of life in chronic urticarial (CU-Q2oL), respectively.Instruments of Urticaria Activity Scoring (UAS) and a questionnaire of quality of life were applied to a group of patients with UC. Some causes of urticaria were assessed by means of history and physical, laboratory tests and autologous serum skin test.Fifty patients with UC were included, of whom 82% were women, with a mean age of 41 years. We observed moderate severity in 58%. Sixty percent of the patients presented a positive anti-IgE autoantibodies test; idiopathic chronic urticarial was seen in 24% of the patients and allergic etiology in 20%. The main impairment in quality of life was related to the pruritus and the function. The relationship between severity and quality of life was meaningful: r2= 0.511 y p<0.0001, with an inverse proportional relation.: We found a clear inverse correlation between the instruments of severity of urticaria and quality of life. The application of both instruments can be very useful in the care of patients with chronic urticaria.
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アレルギー疾患への対応法は,これまでは医学的に病態を把握して治療を行うという視点で論じられてきた.生活者の視点で見る時に,アレルギー診療をスキルミクスで取り組むことや,Quality of Life(QOL)をものさしにするという発想がある.アトピー性皮膚炎でQOLに影響を及ぼす因子は,かゆみ,見た目,治療の負担,不安がある.アトピー性皮膚炎のQOL調査票は,成人ではSkindex-16,Dermatology Life Quality Indexがあり,日本語版がある.小児ではThe Children's Dermatology Life Quality Indexがあり,これにも日本語版がある.低年齢児では,養育者が主に治療を担うため,養育者の負担を評価するものが必要である.Quality of life in Primary Care givers of children with Atopic Dermatitisとその短縮版QP-CAD shortened to 9 questionsがある.患児と養育者双方のQOLを養育者が回答するthe Childhood Atopic Dermatitis Impact Scaleを日本の患者に合わせて修正したJapanese Culturally Modified Version of the Childhood Atopic Dermatitis Impact Scaleが利用できる.生活者の視点で医療を進めていく上で,オープンダイアローグという手法がありえる.
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Chronic forms of urticaria are common, often adversely impacting on quality of life. No formal studies have assessed the extent and nature of disability in different types of urticaria. The Dermatology Life Quality Index (DLQI) is a simple and validated 10-item questionnaire designed to measure and compare disability in different skin conditions. In this study, we aimed to assess the disability in different urticarial groups using the DLQI, allowing comparison with previously published DLQI scores in common skin diseases. The DLQI was administered to 170 consecutive patients attending a specialist urticaria clinic over a 4-month period. Consistent with previous studies using the DLQI, mean scores were not influenced by gender or age. Patients with chronic idiopathic urticaria without a concurrent physical urticaria (n = 47) suffered moderate quality of life impairment (mean +/- SD DLQI 25 +/- 24%). In comparison, patients with chronic idiopathic urticaria with concurrent delayed pressure urticaria (DPU) (n = 26) suffered significantly higher quality of life impairment (mean +/- SD DLQI 43 +/- 23%, 95% confidence interval for difference 7-29%). Disability in this group was greatest in the dimensions of work/study, symptoms/feelings and leisure. Subjects with another form of physical urticaria, cholinergic urticaria, also endured high levels of disability (n = 9, mean +/- SD DLQI 50 +/- 34%). From our urticaria study group, we have shown that subjects with DPU and cholinergic urticaria endure the most quality of life impairment. The mean DLQI scores demonstrated in these groups are comparable with those previously seen in severe atopic dermatitis out-patients (60%) and higher than those seen in out-patients with psoriasis (29.7%), acne (24.3%) and vitiligo (16.1%).
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Abstract Background/Objectives The effect of pediatric psoriasis on quality of life has been demonstrated, but data regarding its influence on caregiver quality of life are scarce. The objective was to investigate how psoriasis affects quality of life of children and their caregivers. Methods This multicenter study included 129 children with psoriasis and their caregivers, who were family members accompanying patients to the clinic. Patient quality of life was measured using the Child Dermatology Life Quality Index. Caregiver quality of life was assessed using Dermatological Family Impact Scale, a 15‐item questionnaire validated for use in the Turkish language. Results Mean Child Dermatology Life Quality Index score was 7.6, indicating a moderate effect on patient quality of life. Symptoms and feelings were the most severely impaired domains of patient quality of life, and emotions was the most severely impaired domain of caregiver quality of life. Dermatological Family Impact Scale score was significantly correlated with Child Dermatology Life Quality Index (correlation coefficient [ r ] = .554, P < .001) and Psoriasis Area and Severity Index ( r = .350, P < .001). Caregivers of patients receiving systemic agents or phototherapy had relative impairment of multiple domains of quality of life compared to caregivers of patients receiving topical treatment only. Conclusion Psychosocial effect of pediatric psoriasis was shown to extend beyond the individual, highlighting the importance of addressing patient and caregiver quality of life concerns in an integrated approach.
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