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临床与真菌学验证皮肤癣菌病严重程度评分及其与患者报告结局指标的相关性。

Clinico-mycological validation of dermatophytosis severity score and its correlation with patient-reported outcome measures.

机构信息

Father Muller Medical College, Mangalore, India.

Department of Dermatology and Venereology, Father Muller Medical College, Mangalore, India.

出版信息

Mycoses. 2024 Aug;67(8):e13783. doi: 10.1111/myc.13783.

Abstract

BACKGROUND

Dermatophytosis impacts a significant portion of the global population. Recent shifts in the disease's presentation, severity and response to treatment, primarily due to emerging drug resistance, underscore the need for reliable assessment tools. The Dermatophytosis Severity Score (DSS) aims to standardise the evaluation of the disease's severity and monitor therapeutic responses.

METHODS

In a cross-sectional pilot study, 25 adults with clinically diagnosed dermatophytosis were evaluated using the DSS. The study also aimed to establish the correlation of DSS with different stages of treatment, dermatophyte species and patient-reported outcomes. Participants were recruited from a dermatology outpatient clinic, and the DSS was applied at baseline, Weeks 4 and 8. The validity and reliability of the DSS were assessed using statistical measures, including Cronbach's alpha and intraclass correlation coefficient.

RESULTS

The study comprised of a near-equal distribution of male (52%) and female (48%) patients, primarily within the age group of 20-39 years. A high recurrence rate of dermatophytosis (60%) was noted, and more than half of the patients (56%) had used topical steroids before presentation. The mean DSS significantly decreased from baseline to the final visit, mirroring the substantial reduction in the 5D itch scale and Dermatology Life Quality Index, with strong positive correlations observed between these measures.

CONCLUSION

The DSS demonstrated high inter-rater reliability and internal consistency, indicating its utility as a reliable clinical tool for assessing dermatophytosis severity. The strong correlation of DSS with itch intensity and quality of life validates its role in patient-centered care. Continued use and further validation of the DSS are recommended to enhance dermatophytosis management and treatment outcomes.

摘要

背景

皮肤癣菌病影响了全球很大一部分人口。由于新兴的耐药性,疾病的表现、严重程度和对治疗的反应发生了最近的变化,这突显了对可靠评估工具的需求。皮肤癣菌病严重程度评分(DSS)旨在标准化疾病严重程度的评估并监测治疗反应。

方法

在一项横断面试点研究中,25 名临床诊断为皮肤癣菌病的成年人使用 DSS 进行了评估。该研究还旨在确定 DSS 与不同治疗阶段、皮肤癣菌物种和患者报告的结果之间的相关性。参与者从皮肤科门诊诊所招募,在基线、第 4 周和第 8 周应用 DSS。使用统计措施(包括 Cronbach's alpha 和组内相关系数)评估 DSS 的有效性和可靠性。

结果

该研究包括男性(52%)和女性(48%)患者的近乎相等分布,主要在 20-39 岁年龄组。注意到皮肤癣菌病的高复发率(60%),超过一半的患者(56%)在就诊前使用过外用类固醇。DSS 评分从基线到最后一次就诊显著降低,与 5D 瘙痒量表和皮肤病生活质量指数的大幅降低相吻合,这些测量之间观察到强烈的正相关。

结论

DSS 表现出高的评分者间可靠性和内部一致性,表明其作为评估皮肤癣菌病严重程度的可靠临床工具的效用。DSS 与瘙痒强度和生活质量的强烈相关性验证了其在以患者为中心的护理中的作用。建议继续使用和进一步验证 DSS,以改善皮肤癣菌病的管理和治疗结果。

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