title: The association of dermatologist-diagnosed and self-reported skin diseases with skin-related quality of life in Latino migrant farmworkers.
abstract: BACKGROUND
  Skin diseases are known to affect the quality of life (QoL), but data to support this are based on clinical samples. Few data document the skin-related QoL in the general population, and whether its association differs with self-reported or dermatologist-diagnosed skin ailments. Farmworkers are at high risk for skin diseases, and are an appropriate population in which to explore these associations.
  
  
  OBJECTIVE
  To compare the association between skin-related QoL and workers' self-reports of skin conditions or dermatologist-diagnosed skin diseases over the course of a work season.
  
  
  METHODS
  Three hundred and four Latino farmworkers were recruited from 45 randomly selected residential sites in North Carolina, USA, for longitudinal surveillance. The participants were interviewed up to five times at 3-week intervals and the reported skin problems and Dermatology Life Quality Index (DLQI) were recorded. Nine digital photographs were taken of each participant. A board-certified dermatologist rated each for the presence of specific skin diseases.
  
  
  RESULTS
  An impact of skin disease on QoL was reported in 16% of interviews. In multivariate analyses with self-reported skin problems, feet or skin fungus, rash, itching, and poison ivy were predictors of QoL. Dermatologist-diagnosed inflammatory diseases and pigmentary disorders were significant predictors of QoL. The association was stronger for self-reported skin problems than for dermatologist-diagnosed conditions.
  
  
  CONCLUSIONS
  In a population of farmworkers, skin problems had a clinically significant impact on QoL. Itch-related conditions and cosmetic conditions, such as acne and melasma, were important determinants of QoL. Treatment for these conditions in this population may enhance QoL.
authors.affiliation: Division of Public Health Sciences, Department of Family and Community Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157, USA. squandt@wfubmc.edu
authors.forename: Sara A
authors.initials: SA
authors.lastname: Quandt
authors.forename: Mark R
authors.initials: MR
authors.lastname: Schulz
authors.forename: Quirina M
authors.initials: QM
authors.lastname: Vallejos
authors.forename: Steven R
authors.initials: SR
authors.lastname: Feldman
authors.forename: Amit
authors.initials: A
authors.lastname: Verma
authors.forename: Alan B
authors.initials: AB
authors.lastname: Fleischer
authors.forename: Stephen R
authors.initials: SR
authors.lastname: Rapp
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Arcury
mesh_terms: D000293:Adolescent; D000328:Adult; D000382:Agricultural Workers' Diseases / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino; D006801:Humans; D007407:Interviews as Topic; D016015:Logistic Models; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D009657:North Carolina; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D012871:Skin Diseases / Q000175:diagnosis / Q000208:ethnology / Q000523:psychology; D011795:Surveys and Questionnaires; D014171:Transients and Migrants