Health-related quality of life in morphoea

Abstract

Background: Little is known about the health-related quality of life (HRQoL) of patients with morphoea, and previous studies have yielded conflicting results.

Objectives: To determine the impact of morphoea on HRQoL, and clinical and demographic correlates of HRQoL in adults.

Methods: This was a cross-sectional survey (n = 73) of the Morphea in Adults and Children cohort.

Results: Morphoea impairs HRQoL in adults. Patients were most impaired by emotional well-being and concerns that the disease would progress to internal organs. Patients with morphoea had worse skin-specific HRQoL than those with nonmelanoma skin cancer, vitiligo and alopecia (lowest P < 0·01). Participants had significantly worse global HRQoL scores than the general U.S. population for all subscales (all P < 0·01), with the exception of bodily pain. Comorbidity (r = 0·35-0·51, all P < 0·01), and symptoms of pruritus (r = 0·38-0·64, all P < 0·01) and pain (r = 0·46-0·74, all P < 0·01) were associated with impairment in multiple domains of skin-specific and global HRQoL. Physician-based measures of disease severity correlated with patient-reported HRQoL.

Conclusions: Patients with morphoea experience a negative impact on HRQoL, particularly if symptoms (pruritus and pain) or concerns regarding internal manifestations are present. Providers should be aware of this when evaluating and treating patients.

Figure 1

Details of HRQOL in morphea as assessed by the Skindex-29+3. Mean skindex subscale scores (A) and mean scores of individual questions within the (B) emotions, and (C) morphea-specific subscales are depicted.

Figure 2

Factors related to HRQOL as measured by the Skindex-29+3. Mean Skindex-29+3 scores are given for (A) ethnicity, (B) Z-AHI, (C) insurance type (unavailable for 2 patients) and (D) disease severity. Z-AHI, Zip-code based annualized household income (unavailable for 7 patients).