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Surgical Treatment
Published in Vineet Relhan, Vijay Kumar Garg, Sneha Ghunawat, Khushbu Mahajan, Comprehensive Textbook on Vitiligo, 2020
Venkataram Mysore, Madhulika Mhatre, Revanta Saha
Patients opting for vitiligo surgery are highly motivated but also have high expectations regarding the outcome. A study demonstrated that patients with high Dermatology Life Quality Index (DLQI) scores responded less favorably to a given therapeutic modality, thereby suggesting that additional psychological approaches may be particularly helpful in these patients [21]. In some patients, failure of surgery may exacerbate underlying stress. We therefore recommend that before undertaking any surgery, patients should be asked to fill out a DLQI form to assess their psychological status and for appropriate counseling and treatment.
Botulinum toxin in the management of focal hyperhidrosis
Published in Anthony V. Benedetto, Botulinum Toxins in Clinical Aesthetic Practice, 2017
David M. Pariser, DeeAnna Glaser
A third method used to measure disease severity is with questionnaires and quality of life scales and patient-reported outcome measurements (PROs). Several such tools are available, including the Dermatology Life Quality Index (DLQI), the Hyperhidrosis Impact Questionnaire (HHIQ), and the Hyperhidrosis Disease Severity Scale (HDSS). The DLQI has 10 items that form six domains such that a total score of 0 is best and 30 indicates the worst quality of life. The HHIQ has items for a baseline evaluation and 10 items used to assess treatment follow-up. It too is most commonly used in clinical trials.24 The HDSS is based on one question that the patient can answer in the office (Table 9.4). The HDSS is a simple tool to use in clinical setting and is responsive to treatment with a one-point HDSS improvement corresponding to approximately a 50% reduction in sweat. This validated scale can aid in selecting patients appropriate for therapy and for assessing effectiveness of treatment.25
Assessment and measurement of disease
Published in M. Alan Menter, Caitriona Ryan, Psoriasis, 2017
Jordan M. Thompson, Abrar A. Qureshi
The Dermatology Life Quality Index (DLQI) is one of the most frequently used general dermatologic tools, with use in hundreds of studies, and versions in over 50 different languages.54,65 Patients respond on a 0–3 Likert scale to 10 questions regarding the impact of skin problems on feelings, daily activities, leisure, work, school, personal relationships, and treatment side effects.56 Over 30 studies have highlighted the DLQI's validity by demonstrating correlation with generic, dermatologic, and disease specific measures of HRQoL. For example, one study showed comparable changes in the DLQI and the more clinical, psoriasis-specific SAPASI tool.57 The DLQI is championed for its ease of use, requiring only 1–2 minutes for completion, and most clinical trials using the DLQI have shown its responsiveness to change before and after treatment.65
Quality of life and patient-reported symptoms in a Phase 4, real-world study of tildrakizumab in patients with moderate-to-severe psoriasis: Week 28 interim analysis
Published in Journal of Dermatological Treatment, 2023
Neal Bhatia, Jayme Heim, Brad Schenkel, J. Gabriel Vasquez
Patients’ HRQoL was evaluated at baseline and at Weeks 4, 8, 12, 16, and 28 using the Psychological General Well-Being Index (PGWBI) and the DLQI. The PGWBI is designed to measure psychological well-being in the general medical population. This HRQoL instrument includes 22 questions representing 6 domains: anxiety, depressed mood, positive well-being, self-control, general health, and vitality. Responses are scored on a Likert scale, in which the answers range from ‘strongly agree’ to ‘strongly disagree’ with gradations in between. The total score ranges from 0 to 110; a higher score indicates greater psychological well-being. The DLQI, which measures HRQoL in patients with skin disease, contains 10 questions which assess patients’ perception of items including symptoms, feelings, daily activities, leisure activities, work or school, personal relationships, and treatment. Each question is scored on a 4-point Likert scale (0 = not at all/not relevant; 1 = a little; 2 = a lot; 3 = very much). Scores of individual items (0–3) are combined to yield a total score of 0–30; higher scores indicate greater impairment of a patient’s skin-related HRQoL (13). Patient-reported severity of itch, pain, and scaling was measured using numerical rating scales (NRSs). The individual NRS instruments for itch, pain, and scaling are all simple, self-administered 11-point scales; scores range from 0 to 10, and higher scores indicate worse symptoms (0 = no itching/pain/scaling to 10 = worst itching/pain/scaling imaginable).
Steps towards implementation of protocolized dose reduction of adalimumab, etanercept and ustekinumab for psoriasis in daily practice
Published in Journal of Dermatological Treatment, 2023
L.S. van der Schoot, J.J. Janssen, M.T. Bastiaens, A. de Boer-Brand, C. Christiaansen-Smit, D.N.H. Enomoto, R. Hovingh, R.A. Tupker, M.M.B. Seyger, L.M. Verhoef, J.M.P.A. van den Reek, E.M.G.J. de Jong
The studied innovation (e.g., protocolized biologic DR) focused on psoriasis patients with stable low disease activity for at least 6 months who were treated with adalimumab, etanercept, or ustekinumab in the standard dose for at least 6 months. The DR protocol was based on a previously conducted randomized trial (19). DR was achieved by injection interval prolongation to 67% and subsequently to 50% of the original dose when Psoriasis Area and Severity Index (PASI) (or description of disease activity) and preferably Dermatology Life Quality Index (DLQI) remained low (scores ≤5). DLQI was incorporated as a flexible criterion to improve the feasibility of the protocol. In case of scores >5 and/or at patients’ request, the previous effective dose or normal dose was resumed. See Figure 1 for the used DR protocol. Visit schedules were performed according to the usual practice in participating hospitals.
Life quality among psoriasis patients based on Dermatology Life Quality Index evaluation and its association with psoriasis severity in China: a cross-sectional study
Published in Annals of Medicine, 2023
Yiran Chen, Lei Wei, Yu Song, Rui Zhang, Le Kuai, Bin Li, Ruiping Wang
The DLQI assessment tool measures how quality of life is affected by skin problems in the past week. The DLQI includes 10 items in seven dimensions: symptoms (Q1), feelings (Q2), daily activities (Q3, Q4), leisure and exercise (Q5, Q6), work or study (Q7), social interaction (Q8, Q9) and treatment (Q10). Patients answered these 10 questions on a scale of 0–3 (0 (not at all), 1 (mild), 2 (severe) and 3 (extremely severe)) based on their performance over the past week. The total DLQI score is 30, with higher scores indicating greater impairment of quality of life. In this study, the DLQI score was classified as 0–1 (no affected), 2–5 (mild affected), 6–10 (moderate affected) and >10 (severe affected), and a severe affected life quality among psoriasis patients was identified when the total DLQI score equalled or exceeded 10 [17].