DLQI-R scoring improves the discriminatory power of theDermatology Life Quality Index in patients with psoriasis,pemphigus and morphea

Background The Dermatology Life Quality Index (DLQI) rates ‘not relevant’responses (NRRs) as the item on the questionnaire having no impact on thepatients’ lives at all. The DLQI-Relevant (DLQI-R) is a recently developed scoringthat adjusts the total score of the questionnaire for the number of NRRs indicatedby a patient.Objectives To compare the discriminatory power of the original and DLQI-R scor-ing approaches in terms of absolute and relative informativity.Methods Cross-sectional data from 637 patients with morphea, pemphigus andpsoriasis were used for the analyses. To assess absolute and relative informativity,Shannon’s index and Shannon’s evenness index were calculated for the 10 itemson the questionnaire and for DLQI and DLQI-R total scores.Results Mean DLQI and DLQI-R scores of patients were 613 vs. 691. In the su b-set of patients wit h NRRs (n = 261, 41%), absolute informativity was higherwith the DLQI-R scoring for all eight items with NRR options in all three condi-tions. The DLQI-R exhibited a better relative informativity in 8, 8 and 6 items inpemphigus, morphea and psoriasis, respectively. The DLQI-R led to an improve-ment in average item-level informativity in all DLQI score bands up to 20 points.Regarding total scores, the DLQI-R produced both a higher absolute and relativeinformativity in all three conditions.Conclusions In patients with morphea, pemphigus and psoriasis, DLQI-R scoringimproves the discriminatory power of the questionnaire by benefiting from theadditional informa tion in NRRs. DLQI-R scoring may be us eful both in clinicalpractice and research. A scoring chart has been developed to aid physicians withscoring

DLQI-R Scoring Improves the Discriminatory Power of the Dermatology Life Quality Index in Patients with Psoriasis, Pemphigus and Morphea

Dermatology Life Quality Index (DLQI) rates 'not relevant' responses (NRRs) as the item of the questionnaire having no impact on the patients' lives at all. DLQI-R is a recently developed scoring that adjusts the total score of the questionnaire for the number of NRRs indicated by a patient.To compare the discriminatory power of the original and DLQI-R scoring approaches in terms of absolute and relative informativity.Cross-sectional data of 637 patients with morphea, pemphigus and psoriasis were used for the analyses. To assess absolute and relative informativity, Shannon's index and Shannon's evenness index were calculated for the 10 items of the questionnaire and for DLQI and DLQI-R total scores.Mean DLQI and DLQI-R scores of patients were 6.13 vs. 6.91. In the subset of patients with NRRs (n=261, 41%), absolute informativity was higher with the DLQI-R scoring for all eight items with NRR options in all three conditions. DLQI-R exhibited a better relative informativity in 8, 8 and 6 items in pemphigus, morphea and psoriasis, respectively. DLQI-R led to an improvement in average item-level informativity in all DLQI score bands up to 20 points. Regarding total scores, DLQI-R produced both a higher absolute and relative informativity in all three conditions.In morphea, pemphigus and psoriasis patients, the DLQI-R scoring improves the discriminatory power of the questionnaire by benefiting from the additional information in NRRs. The DLQI-R scoring may be useful both in clinical practice and research. A scoring chart has been developed to aid physicians with scoring

Supplementary Material for: Successful Treatment of Autoimmune Urticaria with Low-Dose Prednisolone Therapy Administered for a Few Months: A Case Series of 42 Patients

<p><b><i>Background:</i></b> Chronic spontaneous urticaria (CSU) is defined as symptoms of urticaria persisting for 6 weeks or more without obvious cause. Autologous serum skin test (ASST) positivity in patients with CSU is considered to be associated with autoimmune urticaria (AIU). <b><i>Methods:</i></b> In this retrospective study we retrieved the medical records of 1,073 urticaria patients seen at the Department of Dermatology and Allergology of Szeged University between January 2005 and February 2014. Forty-two patients (36 female and 6 male) met the study criteria by having CSU and giving positive results in the ASST. Our aim was to assess the clinical efficacy and safety of low-dose oral prednisolone therapy administered to patients with antihistamine-refractory ASST-positive CSU for a few months. Patients were given an initial dose (40 mg/day) of prednisolone until the complete resolution of the symptoms, usually 7-10 days, and then the dose was gradually decreased, as in other autoimmune diseases. <b><i>Results:</i></b> Prednisolone therapy lasted for an average of 3.6 months and a complete long-lasting response was achieved in 35 of 42 AIU patients (83.3%). The follow-up period was at least 36 months (3 years) for each AIU patient; the longest follow-up time was 139 months (11.5 years). None of the patients reported any considerable side effects. <b><i>Conclusion:</i></b> Based on our results, we suggest that the use of this treatment could be an alternative for the treatment of AIU. Our present results also highlight the need for other therapies in a small percentage of AIU patients. Our results suggest that AIU represents a transient autoimmunity that can be successfully treated with low-dose steroid therapy administered for a few months.</p

DLQI-R scoring improves the discriminatory power of the Dermatology Life Quality Index in patients with psoriasis, pemphigus and morphea

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