Factors associated with quality of life in facial melasma: a cross‐sectional study

Pollo, Camila Fernandes; Miot, Luciane Donida Bartoli; Meneguin, Silmara; Miot, Hélio Amante

doi:10.1111/ics.12464

Cited by 23 publications

(21 citation statements)

References 24 publications

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“…Though these options contribute identically to the final score, they represent different meanings. Moreover, some items, such as q6 (sports) and q9 (sexual life), may elicit different response patterns based on the questioning period, since the instrument evaluates only the last 7 days [13,16,24,61]. A recent proposal to adjust the total DLQI score of the questionnaire for the number of "not relevant" responses (DLQI-R) has the potential to improve the discriminatory power of the instrument, though a systematic psychometric study on item performance has not been performed [61,62].…”

Section: Discussionmentioning

confidence: 99%

“…The content validity of the DLQI has been questioned due to the instrument’s insufficient evaluation of emotional and psychological aspects, which are fundamental in dermatology, especially in asymptomatic but stigmatizing diseases, such as vitiligo, congenital nevus, melasma and alopecia [ 1 , 21 – 24 ]. Furthermore, the plurality of dermatological diseases affects different dimensions of HRQOL.…”

Section: Introductionmentioning

confidence: 99%

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Dimensionality and psychometric analysis of DLQI in a Brazilian population

Jorge

Sousa

Pollo

et al. 2020

Health Qual Life Outcomes

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Background: The Dermatology Life Quality Index (DLQI) is the most commonly used instrument for clinical evaluation of the impact on health-related quality of life (HRQOL) in dermatological research protocols. The DLQI's classical psychometric properties have been considered adequate in validation studies from several countries. However, the structure of the DLQI is a matter of discussion, especially concerning the dimensionality and informative properties of its questions according to the item response theory (IRT). Methods: Pooled data from studies in Brazil that utilized the DLQI to assess HRQOL in 14 dermatoses were reanalyzed. Classical psychometrical analysis, dimensionality assessment through parallel analysis and IRT (Samejima's ordinal model) analysis were performed. Results: The sample consisted of 1286 patients with a mean age of 47 years (SD = 16), and the proportion of women was 59% (765). The DLQI scores ranged from 0 to 29, with a median (p 25-p 75) of 5 (2-11). All items indicated significant correlations with the total DLQI score (rho > 0.54). The Cronbach's alpha result was 0.90 (CI 95% 0.89-0.91). Parallel analysis indicated a unidimensional factor structure. According to IRT analysis, items q6 (sports) and q7 (work/study) exhibited insufficient fit to the model (p < 0.01), while the items that indicated the best discrimination and information functions were q2 (embarrassment), q3 (shopping/gardening), q4 (clothing) and q5 (social/leisure). The ordination of the scores was confirmed for all items. Most items revealed non-uniform behavior according to sex, age and type of disease. Conclusions: The DLQI exhibits adequate psychometric reliability and a unidimensional structure for assessing HRQOL in Brazilian dermatological patients. The DLQI's performance varies in the assessment of HRQOL in heterogeneous samples.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Dimensionality and psychometric analysis of DLQI in a Brazilian population

Jorge

Sousa

Pollo

et al. 2020

Health Qual Life Outcomes

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“…[2][3][4] The chronicity of the disease and the affection of visible areas during working and competitive age inflict a major negative impact on the quality of life. 5,6 The majority of the effective depigmenting agents are tyrosinase inhibitors, of which hydroquinone is the most-studied drug. 3,4 Besides its tolerability, there is some concern regarding the long-term use of topical hydroquinone for melasma because of the risk of exogenous ochronosis and the development of 'confetti' depigmentation as a result of melanocyte toxicity.…”

Section: Introductionmentioning

confidence: 99%

“…Despite the use of broad‐spectrum sunscreen and topical bleaching agents, melasma can be recalcitrant to treatments, and relapses are common 2–4 . The chronicity of the disease and the affection of visible areas during working and competitive age inflict a major negative impact on the quality of life 5,6 …”

Section: Introductionmentioning

confidence: 99%

A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women

Lima¹,

Dias²,

Cassiano

et al. 2020

Int J Dermatology

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Objective To assess the efficacy and safety of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women. Topical 5% cysteamine is an antioxidant and tyrosinase inhibitor that has been shown to be effective in the treatment of melasma. However, to date, no study has compared the performance of topical cysteamine to hydroquinone for facial melasma. Methods A quasi-randomized, multicenter, evaluator-blinded clinical trial was conducted on 40 women with facial melasma who were submitted to the nightly application of 5% cysteamine (CYS) or 4% hydroquinone (HQ) on hyperpigmented areas for 120 days. Both groups were required to use tinted sunscreen (SPF 50; PPD 19). Subjects were assessed at the inclusion and after 60 and 120 days of treatment for mMASI, MELASQoL, and the difference in colorimetric luminosity between melasma and the adjacent unaffected skin. The Global Aesthetic Improvement Scale was used to assess the difference in the appearance of the skin through standardized photographs. Results The mean reduction of the mMASI scores was 24% for CYS and 41% for HQ (P = 0.015) at 60 days, and 38% for CYS and 53% for HQ (P = 0.017) at 120 days. The photographic evaluation revealed up to 74% improvement for both groups, without statistically significant difference between them (P = 0.087). The MELASQoL score showed a progressive decrease for both groups over time, despite the greater reduction for HQ after 120 days (P = 0.018). Colorimetric assessment disclosed progressive depigmenting in both groups, without statistically significant difference between them (P > 0.160). No severe adverse effects were identified in either group. Erythema and burning were the most important local adverse effects with cysteamine, although their frequency did not differ between groups (P > 0.170). Conclusion Cysteamine proved to be safe, well-tolerated, and effective, despite its inferior performance to hydroquinone in decreasing mMASI and MELASQoL in the treatment of melasma.

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“…Although it is not contagious, psoriasis lesions are painful, disfiguring and disabling and cause an important negative impact on the quality of life (World Health Organization, 2016), besides triggering psychological problems, such as low self‐esteem, changes in self‐image, changes in social interactions, depression and anxiety (Pollo et al, 2018).…”

Section: Introductionmentioning

confidence: 99%

Prevalence and factors associated with depression and anxiety in patients with psoriasis

Pollo

Miot

Matos

et al. 2020

Journal of Clinical Nursing

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Objective To identify the prevalence and factors associated with depression and anxiety in patients with psoriasis. Background Psoriasis is a chronic, non‐contagious, autoimmune inflammatory skin disease associated with psychological comorbidities. Design A cross‐sectional study conducted between March 2017–December 2018 in a dermatology infirmary and outpatient clinic of a public hospital in the inner State of São Paulo (Brazil). Methods We used questionnaires with sociodemographic data and clinical history, the HADS (Hospital Anxiety and Depression Scale), DLQI‐BRA (Dermatology Life Quality Index) and PASI (Psoriasis Area Severity Index). The correlations between variables were explored using multivariate techniques. STROBE checklist was applied as the reporting guideline for this study (File S1). Results A total of 281 participants were included, of which the majority were female 146 (52%), with a mean age of 52.1 years (SD: 13.8), elementary school 154 (55%), married/cohabiting 209 (74%) and with low income 201 (72%). The median (p25–p75) time with the disease was 14 years (7–23). Regarding the quality of life, 31% of respondents reported being little affected by the disease. The prevalence of depression was 19% and that of anxiety was 36%. The multivariate analysis showed that the variables that influenced the anxiety and depression scores were as follows: DLQI‐BRA, income, female sex, illness length and age. For the multiple correspondence analysis, the highest levels of anxiety and depression referred to women, middle age, lower income and low PASI. Conclusion The prevalence of anxiety and depression symptoms was low. Female sex, income, age, illness length and quality of life were associated with anxiety and depression scores in patients with psoriasis. Relevance to clinical practice Due to the scarcity of studies in the field of nursing with psoriasis patients, we believe these findings contribute to the reorganisation of the care provided, allowing nurses to timely identify mood disorders such as anxiety and depression and adopt the necessary measures to a service and/or specialised referral.

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Factors associated with quality of life in facial melasma: a cross‐sectional study

Abstract: The perception of life quality impairment in melasma is influenced by low scholarly, low family income, single marital status and greater clinical severity.

Cited by 23 publications

References 24 publications

Dimensionality and psychometric analysis of DLQI in a Brazilian population

Dimensionality and psychometric analysis of DLQI in a Brazilian population

A comparative study of topical 5% cysteamine versus 4% hydroquinone in the treatment of facial melasma in women

Prevalence and factors associated with depression and anxiety in patients with psoriasis

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