Funding sources The study was funded by our Institute, with partial financial support from the Italian Ministry of Health in the frame of the ‘Ricerca Corrente 2012’.
Clinical and Laboratory Investigations
Burden of disease during quiescent periods in patients with pemphigus†
Article first published online: 19 MAY 2014
© 2014 British Association of Dermatologists
British Journal of Dermatology
Volume 170, Issue 5, pages 1087–1091, May 2014
How to Cite
Tabolli, S., Pagliarello, C., Paradisi, A., Cianchini, G., Giannantoni, P. and Abeni, D. (2014), Burden of disease during quiescent periods in patients with pemphigus. British Journal of Dermatology, 170: 1087–1091. doi: 10.1111/bjd.12836
Conflicts of interest None declared.
Plain language summary available online.
- Issue published online: 19 MAY 2014
- Article first published online: 19 MAY 2014
- Accepted manuscript online: 16 JAN 2014 01:50AM EST
- Manuscript Accepted: 7 JAN 2014
- Italian Ministry of Health
Studies conducted using different tools have invariably observed that physical and mental components of health status are seriously compromised in patients with pemphigus. An improvement in quality of life (QoL) has been commonly observed over the treatment period.
The aim of the study is to verify whether the patients' wellbeing is affected by pemphigus also in absence of cutaneous and mucosal lesions.
Materials and methods
The clinical records of 203 patients were analysed. A total of 47 patients were without bullae/erosions and reported a score = 0 for both the Patient Global Assessment and the Ikeda index. In order to assess the QoL we used the Skindex-17 and the 12-item General Health Questionnaire (GHQ-12).
Patients without bullae/erosions had a better QoL when compared with patients with active lesions. This difference, with a reduction of approximately 30% of the Skindex-17 scores in the patients without lesions, was statistically significant, for both the symptoms and the psychosocial scales. The proportion of patients at risk of anxiety/depression (GHQ-positive cases) was 44% lower in patients without lesions compared with patients with lesions. In a multiple linear regression model the presence of bullae/erosions negatively influences QoL with an average increase of Skindex-17 symptoms and psychosocial scale scores of 11·7 and 10·6 points, respectively. Female patients had a statistically significantly worse QoL than males on the symptoms but not on the psychosocial Skindex-17 scales.
While patients without lesions reported a better QoL than patients with bullae/erosions, their Skindex-17 scores remained elevated. Dermatologists should be aware that a clearing of the skin manifestations does not mean ‘perfect health’ for the patient.