Robinson E S, Feng R, Okawa J, Werth V P
Veteran Affairs Medical Center, Philadelphia, PA, U.S.A.; Department of Dermatology, University of Pennsylvania, 1 Convention Avenue, Philadelphia, PA, 19104, U.S.A.
Br J Dermatol. 2015 Jan;172(1):169-74. doi: 10.1111/bjd.13167. Epub 2014 Nov 30.
Cutaneous dermatomyositis (DM) disease activity is associated with decreased quality of life.
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.
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.
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.
This is the first study to demonstrate that the quality of life of patients with DM improved as their cutaneous disease activity decreased.
皮肤型皮肌炎（DM）的疾病活动与生活质量下降相关。
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。
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。
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。
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。
