Measurement of the Impact of Atopic Dermatitis on Patients' Quality of Life: A Cross‐Sectional and Longitudinal Questionnaire Study Using the Japanese Version of Skindex‐16

Abstract

The impact of atopic dermatitis on patients' quality of life was measured using the Japanese version of Skindex-16 in a cross-sectional and longitudinal questionnaire study. One hundred sixty-two adult patients completed Skindex-16 and were followed-up with a standard medical therapy. Three to six months after the initial testing, 135 (83.3%) of the patients again completed Skindex-16 and also answered a general question about whether their skin condition had improved, remained the same, or become worse. The scores of Skindex-16 of 162 patients with atopic dermatitis were significantly higher than those of patients with isolated lesions, particularly in the Symptoms and Emotions scales. Patients with severe atopic dermatitis showed significantly higher scores in the three scales (Symptoms, Emotions, and Functioning), and there was a significant positive correlation between the severity and the 3-scale scores. After the follow-up period, 78 of 135 patients (57.8%) reported that their skin condition had improved. Forty-six patients (34.1%) reported that their skin condition had remained the same, and 11 (8.1%) became worse. Among the patients who said their dermatitis had improved, the scores of Skindex-16 significantly decreased. On the other hand, patients who reported their dermatitis worse showed an increase in the scores. These findings suggest that Skindex-16 responsively measures the disease severity and clinical change in the estimation of the effects of atopic dermatitis on patients' quality of life. This practical and sensitive, skin-disease specific, quality-of-life instrument is valuable for assessing patients' outcomes, especially their response to therapy, and is useful to understanding and improving the quality of life of patients suffering with atopic dermatitis.

A systematic review of patient‐reported outcomes in patients with cutaneous lupus erythematosus

“…The Skindex was generated from published literature and directed‐focus sessions with patients, nurses and physicians . The Skindex has been used in different populations, ranging from those with psoriasis and acne to those with contact dermatitis, and it focuses on three domains – symptoms, emotions and functioning, with scores ranging from 0 (best) to 100 (worst). Skindex‐16 and Skindex‐29 showed evidence of responsiveness and reproducibility .…”

Burden of atopic dermatitis in Asia

“…Some nuances have been observed in the QoL of specific Asian countries. In a study conducted in Japan, patients with AD had significantly higher Skindex‐16 scores than patients with isolated lesions in all three domains (symptoms, emotions and functioning) and the global scale (higher scores reflect worse QoL) . Unsurprisingly, patients with severe disease exhibited significantly worse QoL than patients with mild or moderate disease .…”

Guidelines for management of atopic dermatitis

“…Both Skindex‐16 and the Dermatology Life Quality Index (DLQI) have been analyzed statistically in detail 22–25 and are available in Japanese translations 26–28 …”