title: The impact of onychomycosis on quality of life: development of an international onychomycosis-specific questionnaire to measure patient quality of life.
abstract: BACKGROUND
  Onychomycosis is a widespread refractory disease deleteriously affecting quality of life via social stigma and disrupting daily activities. Many physicians perceive onychomycosis as a cosmetic rather than a medical problem.
  
  
  OBJECTIVE
  Our purpose was to develop a questionnaire-based instrument to quantify the impact of onychomycosis on patients' quality of life.
  
  
  METHODS
  The questionnaire was developed and validated in a multinational cross-sectional study. Completed questionnaires from 532 patients were analyzed: 284 toenail, 248 fingernail (onychomycosis or paronychia).
  
  
  RESULTS
  The degree of quality of life impairment from onychomycosis varied by country studied, possibly reflecting cross-national health perception differences. Longer duration of disease, greater involvement of individual nails, and greater number of nails involved were associated with more serious adverse effects. Many physicians underestimated the associated degree of pain.
  
  
  CONCLUSIONS
  The study confirms that onychomycosis physically and psychologically affects patients' lives. The questionnaire may be a valuable tool in evaluating the effect of therapeutic agents on quality of life of patients with onychomycosis.
authors.affiliation: Department of Dermatology, Massachusetts General Hospital, Boston, USA.
authors.forename: L A
authors.initials: LA
authors.lastname: Drake
authors.forename: D L
authors.initials: DL
authors.lastname: Patrick
authors.forename: P
authors.initials: P
authors.lastname: Fleckman
authors.forename: J
authors.initials: J
authors.lastname: Andr
authors.forename: R
authors.initials: R
authors.lastname: Baran
authors.forename: E
authors.initials: E
authors.lastname: Haneke
authors.forename: C
authors.initials: C
authors.lastname: Sapède
authors.forename: A
authors.initials: A
authors.lastname: Tosti
mesh_terms: D003430:Cross-Sectional Studies; D005260:Female; D005533:Foot Dermatoses / Q000453:epidemiology / Q000523:psychology; D005602:France / Q000453:epidemiology; D005858:Germany / Q000453:epidemiology; D006229:Hand Dermatoses / Q000453:epidemiology / Q000523:psychology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D014009:Onychomycosis / Q000453:epidemiology / Q000523:psychology*; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D014481:United States / Q000453:epidemiology