Disease severity and quality of life in a follow-up study of patients with occupational contact dermatitis.

BACKGROUND: Few studies have investigated how occupational contact dermatitis and its severity affect patients' quality of life (QoL). OBJECTIVES: To investigate the impact of occupational contact dermatitis and its severity on patients' QoL, and to examine the association between different QoL measures. METHOD: Patients previously diagnosed with occupational contact dermatitis completed the Short Form Health Survey (SF-36) and Dermatology Life Quality Index (DLQI). Disease severity was rated both by the patient and by the physician. RESULTS: Of a possible 725, a total of 119 patients (16.4%) were included in the study, and, at follow-up, just over 21% had normal skin and 18.3% had progressed to persistent dermatitis. The SF-36 median physical component summary score was 52 [interquartile range (IQR): 43-56] and the mental component summary median score was 51 (IQR: 44-57). The correlation between patient-rated and physician-rated disease severity was moderate (r = 0.708, p < 0.00001). The correlation between the disease severity measures and DLQI was moderate, whereas the SF-36 correlated poorly with both the DLQI and disease severity measures. CONCLUSIONS: QoL was generally reduced in this group of patients with occupational contact dermatitis, with some correlation between severity and DLQI. The DLQI was a more sensitive measurement of QoL than the SF-36 in this patient population. Incorporating disease severity rating with a QoL questionnaire is valuable in occupational contact dermatitis and is recommended.

A review of the impact of occupational contact dermatitis on quality of life.

Occupational contact dermatitis (OCD) is the most common occupational skin disease in many countries. We reviewed the current evidence on how OCD impacts on quality of life (QoL). The three commonly used QoL questionnaires in OCD were the Short-Form Health Survey (SF-36), the Dermatology Life Quality Index (DLQI), and the Skindex. Despite the availability of a variety of validated QoL instruments, none of them is specific to OCD or entirely adequate in capturing the impact of OCD on QoL. Nonetheless, the results of this paper do suggest a significant impact. Use of QoL measures in clinical settings will provide patients with an opportunity to express their concerns and assist clinicians to evaluate the effectiveness of management beyond the clinical outcomes. This paper also highlights the lack of a disease-specific QOL instrument and the importance of developing a validated measure to assess QOL in OCD, enabling comparison across countries and occupational groups.