Acta Dermato-Venereologica, issue 9 97-9CompleteContent | Page 27

SHORT COMMUNICATION 1145

Advances in dermatology and venereology Acta Dermato-Venereologica

Quality of Life in Greek Patients with Autoimmune Bullous Diseases Assessed with ABQOL and TABQOL Indexes

Aikaterini PATSATSI 1 , Miltiadis KOKOLIOS 1 , Αikaterini KYRIAKOU 1 , Foteini LAMPROU 1 , Despoina STYLIANIDOU 1 , Apostolos TSAPAS 2 , Dimitrios G . GOULIS 3 , Dedee F . MURRELL 4 and Dimitrios SOTIRIADIS 1

1

2 nd Dermatology Department , Medical School , Aristotle University of Thessaloniki , Papageorgiou General Hospital , Ring Road 56403 , N , Efkarpia , Thessaloniki , 2 Clinical Research and Evidence-Based Medicine Unit and 3 Unit of Reproductive Endocrinology , First Department of Obstetrics and Gynecology , Medical School , Aristotle University of Thessaloniki , Thessaloniki , Greece , and 4 Department of Dermatology , St George Hospital , University of New South Wales , Sydney , NSW , Australia . E-mail : katerinapatsatsi @ gmail . com , apatsats @ auth . gr Accepted Jun 28 , 2017 ; Epub ahead of print Jun 29 , 2017

Autoimmune bullous diseases ( AIBD ) place a significant burden on patients ’ quality of life ( QoL ). Specific QoL instruments ( 1 , 2 ), Autoimmune Bullous Diseases Quality of Life ( ABQOL ) ( 1 ) and Treatment Autoimmune Bullous Diseases Quality of Life ( TABQOL ) ( 2 ), were introduced to quantify the impact of AIBD and its treatment on patients ’ well-being . The aim of this study was to assess QoL in Greek patients with AIBD , using the ABQOL and TABQOL questionnaires .

MATERIALS AND METHODS

Patients with newly diagnosed AIBDs were recruited consecutively . Ethical approval was obtained from the local Institutional Review Board and all patients signed an informed consent form . In patients with AIBD in the pemphigus spectrum , the clinical extent and severity were measured with Pemphigus Disease Area Index ( PDAI ) ( 3 ) and Autoimmune Bullous Skin Disorder Intensity Score ( ABSIS ) ( 4 ). Thus , in patients with AIBD in the pemphigoid spectrum , the clinical extent and severity were measured with BPDAI and ABSIS . The questionnaires were handed in at 4 different time points :

• The time point of established diagnosis , at which the patient had the typical clinical picture and no therapy had yet been administered , was defined as baseline ( BL ).

• Time point 2 was the point at which the patients presented with no new lesions ( NL ).

• Time points 3 and 4 were defined as 1 ( M1 ) and 3 months ( M3 ) after baseline , respectively .

Dermatology Life Quality Index ( DLQI ) and ABQOL were completed at all 4 time points ( BL , NL , M1 and M3 ) before the patients were reviewed by the physician . TABQOL was handed out and completed at time points 2 , 3 and 4 ( NL , M1 , M3 ), as at baseline patients had not yet been under treatment and this is a treatment-based questionnaire .

Statistical analysis of the data was performed using the software Statistical Package for Social Sciences ( SPSS ), version 22.0 ( SPSS , Inc ., Chicago , IL , USA ). All tests were 2-sided and the significance level was chosen to be α = 0.05 . Spearman ’ s = r , Friedman ’ s = χ 2 , Wilcoxon = z were used .

RESULTS

Fifty-three patients were invited into the study ; of these , 50 agreed to be included and completed the study . Patients were studied and analysed , after they had been divided into 2 groups based on the disease type ( intraepidermal or subepidermal AIBD ).

Intraepidermal AIBD ( pemphigus spectrum )

At baseline , DLQI was strongly and significantly correlated with both ABSIS ( r = 0.677 , p = 0.006 ) and PDAI ( r = 0.559 , p = 0.03 ). Thus , ABQOL was significantly correlated with PDAI ( r = 0.559 , p = 0.03 ), but not with ABSIS ( r = 0.490 , p = 0.064 ). Moreover , ABQOL was significantly correlated with the initial titres of antidesmoglein 1 ( DSG1 ) ( r = 0.542 , p = 0.037 ), but not with the titres of anti-DSG3 ( r = 0.405 , p = 0.134 ). ABQOL and DLQI were significantly correlated ( r = 0.712 , p = 0.003 ).

A marginal , statistically significant decrease was observed in the median DLQI scores when values at selected consecutive time points were compared ( χ 2 = 6.143 , p = 0.046 ). However , ABQOL scores were significantly different between consecutively selected time points

Table I . Descriptive statistics for DLQI , ABQOL and TABQOL during weeks of evaluation based on the disease type

Variables

BL or NL Median ( range )

M1 Median ( range )

M3 Median ( range )

Friedman test ; p-value

Wilcoxon signed-rank test # BL or NL – M1 M1 – M3 BL or NL – M3

* Statistically significant . # Bonferroni adjustment on the results you get from the Wilcoxon tests because you are making multiple comparisons ; new significance level of 0.05 / 3 = 0.017 .

BL : baseline ; NL : new lesion ; M1 : one month after baseline ; M3 : 3 months after baseline ; N / A : not applicable ; DLQI : Dermatology Life Quality Index ; ABQOL : Autoimmune Bullous Diseases Quality of Life ; TABQOL : Treatment Autoimmune Bullous Diseases Quality of Life .

This is an open access article under the CC BY-NC license . www . medicaljournals . se / acta Journal Compilation © 2017 Acta Dermato-Venereologica . doi : 10.2340 / 00015555-2737 Acta Derm Venereol 2017 ; 97 : 1145 – 1147