Background: Quality of Life (QoL) has become an important outcome parameter in dermatology. Although various dermatology- specific questionnaires have been developed in the last years, many methodological questions on how to evaluate QoL in skin diseases are still unanswered. We previously published the concept of a modular QoL instrument called Freiburg Life Quality Assessment (FLQA) with variants for the use in chronic venous insufficiency, leg ulcer and allergies. Objective: To develop, validate and test a new FLQA variant for the use in chronic skin diseases that includes disease-specific as well as generic components. Methods: An open survey was performed, asking 46 patients with atopic dermatitis, psoriasis and urticaria about the most important psychosocial and physical implications of their disease. The resulting list of answers was further reduced by an expert panel and combined with generic QoL items derived from previously validated variants of the FLQA. The resulting questionnaire (FLQA-d) includes 53 items referring to 6 dimensions of QoL. This questionnaire was validated on 747 patients with chronic skin diseases at admission to hospital. Results: Clinically, patients with atopic dermatitis showed significantly greater reductions of QoL than patients with psoriasis, urticaria and other dermatoses. Regarding the FLQA-d validation, satisfactory results were found with respect to internal consistency, distribution characteristics, test-retest reliability, responsiveness, convergent (construct) validity and discriminant validity. The number of missing data was low. Conclusion: The FLQA-d is a valid and easy-to-use instrument for the evaluation of QoL in chronic dermatoses.

Aim of the present study was a comparison of four quality of life (QoL) questionnaires in 228 patients with psoriasis (PSO, n = 148) and atopic dermatitis (AD, n = 80) regarding feasibility, discriminant validity and sensitivity to change. Evaluating were performed before and after treatment in clinic. The following questionnaires were compared. 1) Freiburg Quality of Life Assessment for Dermatoses (FLQA-d), 2) Dermatology Life Quality Index (DLQI), 3) Chronic Skin Disease Questionnaire (CSDQ) and 4) questionnaire on everyday life (ALLTAG). All questionnaires were able to discriminate significant reductions of QoL in PSO and AD, as compared to controls. In parallel to the clinical improvement, all questionnaires showed QoL improvements as well, i.e. the questionnaires were sensitive to change. However, not all of the DLQI and ALLTAG scales were sensitive to change. Also, in some cases part of the scales of these questionnaires could not be calculated due to missing data. Otherwise, all questionnaires were valid and easy to handle. Thus, QoL of patients with PSO and AD can reliably be assessed by various questionnaires. Decisive for selection are the aim and the design of the study.

The present study examined the effectiveness of combined dermatological and behavioural medicine therapy on the skin status and disease-specific stress of eighty-six patients with psoriasis and fifty-eight patients with atopic dermatitis who were hospitalized in the PsoriSol Clinic, Hersbruck, Germany. In addition to receiving instruction about their stain disease, the patients were offered, practice in relaxation techniques, social contacts and scratching control as well as individual psychological counselling. The clinical change was assessed by PASI and SCORAD, respectively. The Marburg questionnaire for coping with skin diseases (MHF) and a questionnaire for health-related control attributes (GKU-S) served as psychometric measures. Patients showed significant improvement in skin status and psychosocial parameters in pre-post comparison. Social fears, avoidance and helplessness were reduced by significant improvement of the emotional status in both groups. Patients with psoriasis also showed an increase in internal control attributes. Dermatological treatment combined with behavioural medicine therapy can be considered an effective method in patients with atopic dermatitis and psoriasis.

Background: Quality of Life (QoL) is an all-encompassing term which includes all factors influencing the person’s well-being, especially the psychological, social and physical aspects. The QoL of patients with chronic skin diseases may be limited to a great extent. This applies particularly for patients with atopic dermatitis. Usable predictor models for QoL have been tested for clinical use in various diseases (e.g. coronary bypass patients, COPD). However, no studies have been performed on predictors for QoL of patients with skin diseases so far. Objective: Study of the factors influencing QoL of patients with atopic dermatitis. Methods: 254 patients with atopic dermatitis were recruited. The internationally applied disease-specific questionnaire Dermatology Life Quality Index (DLQI) was used as the parameter of QoL. The Questionnaire on Coping with Skin Dis-ease (QCSD) and the Freiburger Questionnaire on Coping with Disease (FQCD) were used as psychometric instruments. The following factors were applied as independent variables: age, sex, age at first diagnosis, duration of disease, clinical score, FQCD total score, and the QCSD scales ‘Social anxieties,’ ‘Itching.’, ‘Helplessness’ and ‘Anxious-depressive mood’. Bivariate correlations and a multiple regression analysis were calculated to determine the influence factors. Results: The QCSD scale ‘Social anxieties’ and the SCORAD contributed most to the variance elucidation of the DLQI total score (T value: 14.81 and 5.71, respectively). The total FQCD score and the QCSD scale ‘Itching’ were also predictors. Overall, a variance elucidation of 64% resulted from the independent variables. Conclusion: Identification of specific predictive factors in QoL could help in designing differentiated therapies for patients with atopic dermatitis and in improving the QoL of these patients.

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