Quality of life indices.

The measurement of the impact of skin diseases on patients' quality of life is important. This review explains the reasons for this, explains the main methods of measuring quality of life in dermatology and describes recent research in this area. Virtually all aspects of patients' lives can be affected by skin disease. It is important to be able to measure this effect for clinical, therapeutic and health service research, for political purposes and potentially to inform clinical decisions. Measurement techniques include general health, disease specific and dermatology specific questionnaires: experience with the Dermatology Life Quality Index (DLQI) is described. Utility measures can also be used to gain insight into the value that patients place on their disease. There are special issues relating to the assessment of quality of life in children: a cartoon version of a questionnaire has been developed to enhance patient friendliness. The lives of the families of patients with skin disease may be affected and this impact can also be measured. In the clinic, complex clinical decisions, for example relating to starting systemic therapy, may be aided by better knowledge of the impact of disease on individuals, but measures will only be helpful if clinicians can easily interpret scores: the concept of score banding to aid this is described.