Skin disease disability: measuring its magnitude.

Skin diseases cause considerable discomfort, but usually do not affect patients' lifespan. However the effects of skin disease on patients' lives can be profound, as all aspects of life can be interfered with. Methods to measure these effects on life quality are needed for clinical, research, audit and political reasons. General health questionnaires such as the Sickness Impact Profile or the Short Form 36 can be used to compare the impact of skin disease to the impact of diseases of other systems. Disease specific questionnaires such as the Psoriasis Disability Index, dermatology specific measures such as the Dermatology Life Quality Index (DLQI), and utility measures can all be used in dermatology and have their different specific indications. The use of the DLQI has quantified the major impact that inflammatory skin disease has on patients and has been used to demonstrate the improvement resulting from systemic therapy and from inpatient management. A version for use in children has also been described. The information gained from this work can be used to demonstrate the importance of adequately managing skin disease in the community and can help to guide resource allocation.