Background-Quality of life (QoL) for patients with inflammatory skin disease can be significant, but has been evaluated in just one study in dermatomyositis (DM).

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Background To properly evaluate therapies for cutaneous dermatomyositis (DM), it is essential to administer an outcome instrument that is reliable, valid, and responsive to clinical change, particularly when measuring disease activity. Objective The purpose of this study is to compare two skin-severity DM outcome measures, the Cutaneous Disease and Activity Severity Index (CDASI) and the Cutaneous Assessment Tool-Binary Method (CAT-BM), with the physician global assessment (PGA) as the ‘gold standard’. Methods Ten dermatologists evaluated fourteen patients with DM using the CDASI, CAT-BM, and PGA scales. Inter-, intra-rater reliability, validity, responsiveness, and completion time were compared for each outcome instrument. Responsiveness was assessed from a different study population, where one physician evaluated 35 patients with 110 visits. Results The CDASI was found to have a higher inter- and intra-rater reliability. Regarding construct validity, both the CDASI and the CAT-BM were significant predictors of the PGA scales. The CDASI had the best responsiveness among the three outcome instruments examined. The CDASI had a statistically longer completion time than the CAT-BM by about 1.5 minutes. Limitations The small patient population may limit the external validity of the findings observed. Conclusions The CDASI is a better clinical tool to assess skin severity in DM.

Background Little is known about the prevalence of self-reported photosensitivity and its effects on quality of life in a U.S. cutaneous lupus population Objective We sought to determine the prevalence of self-reported photosensitivity among a cutaneous lupus population and to examine its impact on quality of life Methods 169 subjects with lupus were interviewed about photosensitivity symptoms and completed the modified Skindex-29+3, a quality of life survey. A complete skin exam was conducted and the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI) was completed. Results 68% of subjects reported some symptoms of photosensitivity (PS). The PS group (subjects who reported a history of and current photosensitivity) scored worse on photosensitivity-related items of the modified Skindex-29+3 and had higher cutaneous disease activity as determined by the CLASI. Photosensitive patients had worse symptoms and emotions and experienced significant functional impairments compared to patients with cutaneous lupus but without photosensitivity. Limitations This study was done at a single-referral center Conclusions Self-reported photosensitivity is very common among cutaneous lupus patients and is associated with significant impairments related to symptoms, emotions, and daily functioning.