Impaired quality of life in patients with systemic sclerosis compared to the general population and chronic dermatoses

Abstract

BackgroundSystemic sclerosis (SSc) is a rare and potentially life threatening autoimmune disorder. The burden of disease compared to other dermatoses is unknown. The purpose of this study was to assess both the quality of life in patients with SSc and the variables that are associated with poor quality of life. Forty-one patients with systemic sclerosis (29 limited, 2 diffuse, 10 undifferentiated forms) were assessed with respect to their health status and compared to published data for the normal population, SSc patients from other studies, and patients with chronic skin diseases.ResultsFor the most part, our SSc patients had better outcomes in all 8 dimensions of the SF-36 than SSc patients from other studies, and poorer scores than the healthy population and those with occupational contact dermatitis, ichthyosis, non-melanoma skin cancer, contact dermatitis, atopic eczema, chronic nail disease, vitiligo, health care workers with work-related disease, and those with other chronic skin diseases, but significantly better scores for mental health than those with nail disease, vitiligo, and health-care workers. Patients with atopic dermatitis, psoriasis and pemphigus had significantly poorer mean scores in social function and mental health than SSc patients. Patients with pemphigus were also significantly impaired in their physical and emotional roles. Patients with systemic lupus erythematosus (SLE) had the significantly poorest mean scores for QoL in all 8 domains except bodily pain and emotional role.ConclusionBesides SLE, SSc is one of the most severe chronic dermatologic diseases in terms of reduced QoL. Since SSc cannot be cured, treatment strategies should include therapeutic interventions such as psychotherapy, social support, physiotherapy, and spiritual care. Their beneficial effects could be studied in future.

Efeitos da cinesioterapia sobre a força de preensão palmar e a qualidade de vida de um idoso longevo com esclerose sistêmica: relato de caso

“…Embora saiba-se que a QV de indivíduos com ES seja prejudicada, especialmente em idosos [13][14][15] , e que a capacidade de gerar força tende a diminuir com o avanço da idade 19 , até o presente momento não haviam registros sobre a correlação da FPP e QV em idosos com ES. Este estudo demonstrou que com o aumento da FPP houve também melhora dos escores dos domínios da QV em um idoso longevo com ES.…”

“…Estudos atuais referenciam que a QV de indivíduos com ES possa ser impactada negativamente em aspectos físicos e cognitivos se comparado com indivíduos sem a patologia, inclusive nos idosos [13][14][15] . A funcionalidade pode ser mantida através da fisioterapia, sobretudo a cinesioterapia, a qual tem papel fundamental no tratamento da ES por prevenir os agravos osteomioarticulares, como os quadros de dor, as contraturas e a diminuição da amplitude do movimento e da força muscular, além de proporcionar a melhora e a manutenção da QV destes acometidos 6,15 .…”

Physiotherapeutic intervention on pain and quality of life of systemic sclerosis elderly patients. Case reports

“…In chronic situations, pain goes beyond the physiological period of tissue healing, causing physical and cognitive incapacity or impairing patients' wellbeing and QL 15 . So, QL of SS patients may be impaired as compared to healthy individuals 16 , because it is inversely correlated to pain 9 . This is suggested by our study, because results have shown that when QL scores improved, pain scores decreased.…”

Quality of life in systemic sclerosis

“…Salt and pepper appearance was the cutaneous finding that had association with high dermatology life quality index scores [16]. In SSc patients skin remission cannot be achieved like in others dermatoses (psoriasis, atopic dermatitis, pemphigus, or SLE) [10] and so the social factors and disease coping may contribute to a better mental health [84][85][86].…”