The association of dermatologist-diagnosed and self-reported skin diseases with skin-related quality of life in Latino migrant farmworkers

Abstract

Background: Skin diseases are known to affect the quality of life (QoL), but data to support this are based on clinical samples. Few data document the skin-related QoL in the general population, and whether its association differs with self-reported or dermatologist-diagnosed skin ailments. Farmworkers are at high risk for skin diseases, and are an appropriate population in which to explore these associations.

Objectives: To compare the association between skin-related QoL and workers' self-reports of skin conditions or dermatologist-diagnosed skin diseases over the course of a work season.

Methods: Three hundred and four Latino farmworkers were recruited from 45 randomly selected residential sites in North Carolina, USA, for longitudinal surveillance. The participants were interviewed up to five times at 3-week intervals and the reported skin problems and Dermatology Life Quality Index (DLQI) were recorded. Nine digital photographs were taken of each participant. A board-certified dermatologist rated each for the presence of specific skin diseases.

Results: An impact of skin disease on QoL was reported in 16% of interviews. In multivariate analyses with self-reported skin problems, feet or skin fungus, rash, itching, and poison ivy were predictors of QoL. Dermatologist-diagnosed inflammatory diseases and pigmentary disorders were significant predictors of QoL. The association was stronger for self-reported skin problems than for dermatologist-diagnosed conditions.

Conclusions: In a population of farmworkers, skin problems had a clinically significant impact on QoL. Itch-related conditions and cosmetic conditions, such as acne and melasma, were important determinants of QoL. Treatment for these conditions in this population may enhance QoL.