Atopic dermatitis (AD) is a frequent and burdensome disease. The objectives of this study were (1) to assess the willingness to pay (WTP) and quality of life (Qol) in AD patients and (2) to compare the results with data on other chronic skin diseases. To collect data, a non-interventional, cross-sectional nationwide postal survey on adult patients with clinically diagnosed AD was performed; socio-demographic data, clinical features/symptoms, WTP and QoL were recorded. WTP was assessed in three different approaches, including relative and absolute figures. Data from n = 384 AD patients (mean age 42.0, range 18-92, 69.8 % female) were analyzed. WTP for complete healing was on median 1,000 (average 11,884) and exceeded WTP in rosacea (median 500) but not in vitiligo (median 3,000). Mean Dermatology Life Quality Index (DLQI) was 8.5 (vitiligo 7.0; psoriasis 6.7; rosacea 4.3) and correlated with pruritus, xerosis and disturbed sleep. WTP and DLQI correlated only marginally (r s = 0.134, p = 0.01). In conclusion, AD patients show high WTP and markedly reduced QoL compared to other chronic skin diseases.

Rosacea patients show a moderate WTP and average QoL reduction is mild. WTP proved to be a valid tool to assess patients' burden of disease. Patient education and the development of effective treatment options might still improve patients' satisfaction.

Nail involvement in psoriasis is common and mostly occurs with other lesions but can also occur alone. Besides psychosocial and aesthetic impairments, patients often complain about functional impairment. Nail psoriasis is a predictor for more severe psoriasis, decreased quality of life, and a higher risk for the development of psoriatic arthritis. Onychomycosis and other differential diagnoses should be excluded prior to treatment. This article presents an overview of different clinical appearances of nail psoriasis, the essential diagnostic assessment before treatment, important differential diagnoses, and published data on treatment options for nail psoriasis.

In many countries, utility measures are required for allocation decisions. Unlike the EuroQoL-5D (EQ-5D), the dermatology life quality index (DLQI) has not been developed for the derivation of utilities. Purpose of this study was to develop and test an algorithm for the transformation of DLQI scores into utilities. Pre-existing data of two cross-sectional studies (for development, n = 1,511; for cross-validation n = 2,009) of German psoriasis patients were reanalyzed. Both EQ-5D global score and EQ-5D visual analogue scale (VAS) were used as utility measures. Correlations were computed to identify predictors of EQ-5D utilities. Linear stepwise regressions were conducted using DLQI and further possible predictors to find the optimal mapping algorithm. Using only DLQI as predictor resulted in coefficients of determination of r (2) = 0.235 (EQ-5D global score) and r (2) = 0.242 (EQ-5D VAS). In the final algorithm, seven predictors were included which correctly predicted EQ-5D VAS for 60.4 % (development database) and 60.8 % of all patients (cross-validation database) within a range of ±15 units. The algorithm explained 31.3 % of the EQ-5D variance in the development database and 26.8 % in the cross-validation database. In conclusion, mapping of DLQI on EQ-5D in psoriasis patients has severe limitations in validity and clinical relevance.