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皮肌炎患者皮肤疾病活动度的改善与生活质量的提高相关。

Improvement in the cutaneous disease activity of patients with dermatomyositis is associated with a better quality of life.

作者信息

Robinson E S, Feng R, Okawa J, Werth V P

机构信息

Veteran Affairs Medical Center, Philadelphia, PA, U.S.A.; Department of Dermatology, University of Pennsylvania, 1 Convention Avenue, Philadelphia, PA, 19104, U.S.A.

出版信息

Br J Dermatol. 2015 Jan;172(1):169-74. doi: 10.1111/bjd.13167. Epub 2014 Nov 30.

Abstract

BACKGROUND

Cutaneous dermatomyositis (DM) disease activity is associated with decreased quality of life.

OBJECTIVES

To assess if an improvement in quality of life, as measured by the Skindex-29 and patient-reported itch and pain on a 10-point visual analogue scale (VAS), correlated with an improvement in cutaneous DM disease activity.

METHODS

Patients with a completed cutaneous DM disease area and severity index [Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)] at two visits separated by at least 2 months were classified into responder (n = 15) and nonresponder (n = 30) groups according to the point change in the CDASI activity scores between visits. Responders had at least a four-point improvement in CDASI activity, indicating clinically relevant improvement.

RESULTS

The change from baseline to the follow-up visit of the Skindex-29 subscale scores for the responders vs. the nonresponders were significantly different for emotions (P < 0·01), functioning (P < 0·01) and symptoms (P < 0·01). The change in VAS score between responders and nonresponders was also significant for itch (P = 0·01) and pain (P = 0·04). There was no significant difference between the groups in terms of disease subtype, sex, race, age, treatment for DM, smoking history or a history of malignancy within 5 years of a diagnosis of DM.

CONCLUSIONS

This is the first study to demonstrate that the quality of life of patients with DM improved as their cutaneous disease activity decreased.

摘要

背景

皮肤型皮肌炎(DM)的疾病活动与生活质量下降相关。

目的

评估通过Skindex-29量表以及患者报告的10分视觉模拟量表(VAS)上的瘙痒和疼痛所衡量的生活质量改善是否与皮肤型DM疾病活动的改善相关。

方法

在至少间隔2个月的两次就诊时完成皮肤型DM疾病面积和严重程度指数[皮肤型皮肌炎疾病面积和严重程度指数(CDASI)]评估的患者,根据两次就诊之间CDASI活动评分的变化点分为缓解组(n = 15)和未缓解组(n = 30)。缓解者的CDASI活动至少改善4分,表明有临床相关改善。

结果

缓解者与未缓解者相比,从基线到随访时Skindex-29子量表评分在情绪(P < 0·01)、功能(P < 0·01)和症状(P < 0·01)方面的变化有显著差异。缓解者与未缓解者之间在VAS评分的瘙痒(P = 0·01)和疼痛(P = 0·04)方面的变化也有显著差异。两组在疾病亚型、性别、种族、年龄、DM治疗、吸烟史或DM诊断后5年内的恶性肿瘤病史方面无显著差异。

结论

这是第一项表明随着皮肤疾病活动度降低,DM患者生活质量得到改善的研究。

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