Ongenae K, Van Geel N, De Schepper S, Naeyaert J M
Department of Dermatology, Ghent University Hospital, De Pintelaan 185, B-9000 Gent, Belgium.
Br J Dermatol. 2005 Jun;152(6):1165-72. doi: 10.1111/j.1365-2133.2005.06456.x.
Vitiligo is a pigmentary disorder affecting at least 1% of the total population. Although the disease does not produce direct physical impairment, it may considerably influence the psychological well-being of the patients. It has been suggested that patients suffer from low self-esteem, poor body image and a poor quality of life. The majority of the studies on the psychosocial impact of vitiligo were conducted in the U.S.A. and England.
This study aims to quantify the burden of vitiligo by estimating health-related quality of life in the Dutch-speaking Belgian population (Flanders). This is compared with the level of disability caused by psoriasis in a similarly recruited population. It is also our purpose to detect those at risk of experiencing a poor quality of life and to identify variables that might predict this impairment.
Patients with vitiligo (n = 119) and 162 patients with psoriasis were included in a postal survey. In order to obtain a patient-based measurement of quality of life we used the Dermatology Life Quality Index (DLQI), a widely validated questionnaire that is easy to use and allows comparison between several skin disorders. Other survey questions were related to demographic data and disease-related characteristics.
We obtained excellent response rates in both patient groups. The overall mean DLQI score for vitiligo (4.95) was lower than that for psoriasis (6.26) (P = 0.01). Patients with vitiligo experienced significantly less impairment of life quality from the symptoms and treatment of the disease (P < 0.001). The highest individual mean scores in vitiligo were found for Q2 (feelings), Q4 (clothing), Q5 (social and leisure activities) and Q3 (daily routine). The interaction of disease and sex on the DLQI score was highly significant (P = 0.001). While men with vitiligo scored significantly lower than men with psoriasis (P < 0.001), we found a comparable overall DLQI score for women in these disease groups. The number of consultations (P = 0.005) and severity of the disease (P < 0.001) were independently related to the DLQI.
Our study quantifies the burden on the quality of life caused by vitiligo and indicates specific areas of patients' lives which are most affected by the disease. Sex, number of consultations and subjective disease severity independently predict the quality of life. The quality of life impairment in women affected with vitiligo equals the impairment caused by psoriasis in our study population. These results should awake the interest of physicians in this 'cosmetic' disease, since appropriate treatment is likely to improve the quality of life of vitiligo patients.
白癜风是一种色素沉着紊乱疾病，影响着至少1%的总人口。尽管该疾病不会造成直接的身体损伤，但它可能会对患者的心理健康产生相当大的影响。有人认为患者会出现自卑、不良的身体形象和较低的生活质量。大多数关于白癜风心理社会影响的研究是在美国和英国进行的。
本研究旨在通过评估荷语区比利时人群（弗拉芒大区）与健康相关的生活质量来量化白癜风的负担。将其与在类似招募人群中银屑病所导致的残疾程度进行比较。我们的目的还包括检测那些生活质量可能较差的风险人群，并确定可能预测这种损害的变量。
白癜风患者（n = 119）和162名银屑病患者纳入了一项邮寄调查。为了获得基于患者的生活质量测量结果，我们使用了皮肤病生活质量指数（DLQI），这是一份经过广泛验证的问卷，易于使用，且能对几种皮肤病进行比较。其他调查问题涉及人口统计学数据和疾病相关特征。
我们在两个患者组中都获得了很高的回复率。白癜风患者的总体平均DLQI得分（4.95）低于银屑病患者（6.26）（P = 0.01）。白癜风患者因疾病症状和治疗而经历的生活质量损害明显更少（P < 0.001）。白癜风患者个体平均得分最高的项目是Q2（感受）、Q4（着装）、Q5（社交和休闲活动）和Q3（日常生活）。疾病与性别在DLQI得分上的交互作用非常显著（P = 0.001）。白癜风男性患者的得分显著低于银屑病男性患者（P < 0.001），而我们发现这些疾病组中女性的总体DLQI得分相当。就诊次数（P = 0.005）和疾病严重程度（P < 0.001）与DLQI独立相关。
我们的研究量化了白癜风对生活质量造成的负担，并指出了患者生活中受该疾病影响最严重的具体方面。性别、就诊次数和主观疾病严重程度可独立预测生活质量。在我们的研究人群中，患白癜风女性的生活质量损害程度与银屑病患者相当。这些结果应引起医生对这种“美容”疾病的关注，因为适当的治疗可能会改善白癜风患者的生活质量。
