Grob J J, Revuz J, Ortonne J P, Auquier P, Lorette G
Service de Dermatologie, Hôpital Henri Mondor, Créteil, France.
Br J Dermatol. 2005 Feb;152(2):289-95. doi: 10.1111/j.1365-2133.2005.06385.x.
A better management of chronic skin disorders (CSDs) requires a knowledge of their impact from the patient's point of view.
To determine which aspects of the patient's life are mainly impaired in the different CSDs, and provide comparative references to estimate better the real impact of the different CSDs.
A prospective cross-sectional and matched study of 1356 adult outpatients to compare the health-related quality of life (HRQL) profile in chronic urticaria (466 CU), psoriasis (464 PSO) and atopic dermatitis (426 AD), using the VQ-Dermato, a multidimensional instrument in French validated for CSDs.
After adjustment for confounders, HRQL dimensions were differently affected in the three CSDs. The 'physical discomfort' dimension was more degraded in AD and CU than in PSO (P < 0.001), and 'leisure activities' more in PSO than in CU (P < 0.001). 'Self-perception' and 'treatment-induced restrictions' dimensions were much less affected in CU than in PSO and AD (P < 0.001). In PSO, the 'daily living activities' dimension was much less impaired than in CU and AD (P < 0.001). No aspect of HRQL was really spared in AD.
The comparison shows that CU, PSO and AD are characterized by completely different qualitative profiles of impact on HRQL, which are influenced by their clinical characteristics and usual treatment options. It underlines the severe impairment of CU which is often underestimated.
要更好地管理慢性皮肤疾病（CSDs），需要从患者的角度了解其影响。
确定不同慢性皮肤疾病中患者生活的哪些方面受到的影响最大，并提供比较参考，以便更好地评估不同慢性皮肤疾病的实际影响。
对1356名成年门诊患者进行前瞻性横断面匹配研究，使用经法国验证适用于慢性皮肤疾病的多维工具VQ-Dermato，比较慢性荨麻疹（466例）、银屑病（464例）和特应性皮炎（426例）患者的健康相关生活质量（HRQL）概况。
在对混杂因素进行调整后，三种慢性皮肤疾病对HRQL维度的影响各不相同。“身体不适”维度在特应性皮炎和慢性荨麻疹患者中比在银屑病患者中下降得更明显（P < 0.001），“休闲活动”维度在银屑病患者中比在慢性荨麻疹患者中下降得更明显（P < 0.001）。“自我认知”和“治疗引起的限制”维度在慢性荨麻疹患者中受到的影响远小于银屑病和特应性皮炎患者（P < 0.001）。在银屑病患者中，“日常生活活动”维度受到的损害远小于慢性荨麻疹和特应性皮炎患者（P < 0.001）。在特应性皮炎患者中，HRQL的任何方面都没有真正幸免。
比较表明，慢性荨麻疹、银屑病和特应性皮炎对HRQL的影响在性质上完全不同，这受到它们的临床特征和常用治疗方法的影响。这凸显了慢性荨麻疹常被低估的严重损害。
