Measure of Quality of Life Quantitative Approach

A quantitative approach for measuring QoL in HS was performed [2]. Questionnaires widely used in other skin diseases such as the Dermatology Life Quality Index (DLQI) questionnaire, Skindex and VQ-Dermato [1, 4, 5] were chosen. This approach allows a direct comparison of the results with those from previous studies on other skin diseases. We will discuss two studies, one already published and our unpublished data [2]. In both studies, in addition to this questionnaire, basic demographic data and aspects of the history of HS were collected: 114 patients participated in the first one [2] and 61 in the second. In the study of der Werth and Jemec [2] the recorded mean DLQI score was 8.9, higher than scores found in several other dermatological conditions such as alopecia, acne, psoriasis, Hailey-Hailey disease, vascular anomalies of face, and atopic dermatitis. In our center (unpublished data) using two other skin-disease-specific QoL questionnaires (Skindex and VQ-Dermato) [1, 5], the scores obtained were higher than those found in chronic urticaria, psoriasis, atopic dermatitis and also neurofibromatosis 1.

The impact upon QoL was correlated with the number of active lesions and with the severity of the disease. Therefore, QoL questionnaires can be used to measure the activity of the disease from the viewpoint of patients and could be used in therapeutics trials as a main criterion. In our study, three QoL questionnaires were administered and the measures obtained from each of them were strongly correlated. One can recommend using only one questionnaire and preferably one dermatological questionnaire, such as DLQI, VQ-dermato or Skindex, which seem to be more sensitive [1, 4, 5].

The DLQI score was inversely correlated with age at disease onset [2]. It was suggested that patients with late-onset disease tend to have an overall milder form of HS and a better chance of spontaneous recovery than those who develop the condition earlier in life. This is in agreement with a previous observation of the outcome of simple surgical procedures in HS, where older patients appeared to have fewer recurrences.

We used QoL questionnaires concomitantly with a VAS for pain. The QoL scores were strongly and positively correlated with the pain. Indeed, soreness and pain are the most commonly cited reason for impaired health in HS. It is self-evident that pain is one of the main burdens of patients with HS and should be taken into account as an evaluation criterion for future treatment. Patients with a long disease duration and continuous evolution were more affected than those with intermittent evolution. A pelvic location had a significantly higher impact compared to other locations. Indeed this location is associated with boils with a malodorous discharge leading to an evident physical limitation.

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