Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil).

OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI). METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP). DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86%), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82% of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher than Hansen's disease, psoriasis, atopic eczema, and basal cell carcinoma. The presence of angioedema was associated with higher scores: 14.5 x 9.9 (p < 0.01). Female patients reported greater impact on clothing, while male patients reported treatment interference with work and study (p < 0.05). CONCLUSION: Chronic urticaria seriously compromises the quality of life of patients evaluated at a university service in Brazil, particularly of patients with angioedema.

Qualidade de vida em urticária crônica: inquérito em ambulatório público universitário, Botucatu (Brasil) / Quality of life in chronic urticaria: a survey at a public university outpatient clinic, Botucatu (Brazil)

OBJETIVO: Avaliar o impacto da urticária crônica na qualidade de vida dos pacientes de ambulatório universitário a partir do questionário DLQI (Dermatology Life Quality Index). MÉTODOS: Inquérito sobre o impacto na qualidade de vida infligido pela urticária crônica a partir do questionário DLQI validado para a língua portuguesa. Pacientes foram entrevistados durante suas consultas em ambulatório especializado, entre maio de 2009 e maio de 2010, em serviço público brasileiro (Botucatu-SP). Os escores do DLQI foram analisados segundo subgrupos: idade, gênero, escolaridade, tempo de doença e presença de angioedema. RESULTADOS: Foram entrevistados 100 pacientes com urticária crônica. Predominou o gênero feminino (86 por cento), a idade média foi de 41,8 anos, duração média da doença foi de seis anos e angioedema ocorreu em 82 por cento dos pacientes. O escore médio do DLQI foi de 13,5, caracterizando grave impacto à qualidade de vida, superior a hanseníase, psoríase, eczema atópico e carcinoma basocelular. Presença de angioedema se associou a maiores escores: 14,5 x 9,9 (p < 0,01). Pacientes do gênero feminino referiram maior impacto quanto ao vestuário, já o gênero masculino referiu quanto ao tratamento, trabalho e estudo (p < 0,05). CONCLUSÃO: Urticária crônica inflige grave comprometimento da qualidade de vida nos pacientes avaliados em serviço universitário brasileiro, especialmente nos portadores de angioedema.

OBJECTIVE: To evaluate the impact of chronic urticaria on quality of life of outpatients through the university questionnaire Dermatology Life Quality Index (DLQI). METHODS: Survey of the impact on quality of life caused by chronic urticaria, using the DLQI questionnaire validated for the Portuguese language. Patients were interviewed during visits to a specialized outpatient clinic between May 2009 and May 2010 at a Brazilian public service (Botucatu-SP). DLQI scores were analyzed according to the following subgroups: age, gender, education, disease duration, and presence of angioedema. RESULTS: We interviewed 100 patients with chronic urticaria. There was a female predominance (86 percent), mean age 41.8 years, mean disease duration of 6 years, and angioedema occurrence in 82 percent of patients. The mean DLQI score was 13.5, characterized by serious impact on quality of life, higher than Hansen's disease, psoriasis, atopic eczema, and basal cell carcinoma. The presence of angioedema was associated with higher scores: 14.5 x 9.9 (p < 0.01). Female patients reported greater impact on clothing, while male patients reported treatment interference with work and study (p < 0.05). CONCLUSION: Chronic urticaria seriously compromises the quality of life of patients evaluated at a university service in Brazil, particularly of patients with angioedema.

Role of stressful life events in induction or exacerbation of psoriasis and chronic urticaria.

BACKGROUND: The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Previous reports addressing its influence on skin psoriasis and chronic urticaria have been mainly anecdotal. OBJECTIVE: The aim of this study was to evaluate the stressful events of life within 1 year preceding onset or exacerbation of skin disease in patients of psoriasis vulgaris and chronic urticaria. METHOD: Fifty consecutive clinically diagnosed psoriasis patients and 50 consecutive clinically diagnosed chronic urticaria patients were examined clinically and administered Gurmeet Singh's presumptive stressful life events scale. RESULTS: Stressful life events were seen in 26% of the patients in the psoriasis vulgaris group and 16% of the patients in the chronic urticaria group within 1 year preceding onset or exacerbation of skin disease. In the psoriasis vulgaris group, the most common stressful life event seen was financial loss or problems (8%), followed by death of close family member (4%), sexual problems (4%), family conflict (2%), major personal illness or injury (2%), and transfer or change in working conditions (2%), failure in examinations (2%), family member unemployed (2%), illness of family member (2%), getting married or engaged (2%), miscellaneous (2%). In the chronic urticaria group, the most common stressful life event seen was death of a close family member (6%), followed by family conflict (2%), financial loss or problems (2%), sexual problems (2%), illness of family member (2%), getting married or engaged (2%), trouble at work with colleagues, superiors, or subordinates (2%), going on a pleasure trip (2%) and extramarital relations (2%). CONCLUSION: Psychological stress plays a significant role in triggering or exacerbating dermatological diseases. Our study indicates the role of relaxation therapies and stress management programs in chronic diseases such as psoriasis and chronic urticaria. Psychological interventions can help individuals to reinterpret events and develop strategies to cope with stressful events, thus decreasing morbidity due to these diseases.