title: Quality of life in patients with pemphigus receiving adjuvant therapy.
abstract: BACKGROUND
  Pemphigus has a strong effect on patients' quality of life (QOL).
  
  
  OBJECTIVE
  To analyze QOL and psychological well-being within patient groups, subdivided according to their different adjuvant treatments.
  
  
  METHODS
  All adult patients with pemphigus enrolled in the study were assessed using the Short Form (SF)-36, the Skindex-29, and the General Health Questionnaire (GHQ)-12 for health status, effect of dermatology-specific aspects, and the presence of psychological comorbidity, respectively. The study population was subdivided into the following treatment groups: (i) those who were untreated or were treated only with corticosteroids (CS) at a dose of ≤ 5 mg/day (no adjuvant treatment, NAT); and patients receiving or not receiving CS ≤ 5 mg/day who also received either (ii) azathioprine (AZ), (iii) cyclophosphamide (CY), (iv) mycophenolate mofetil (MM) or (v) rituximab (RTX).
  
  
  RESULTS
  In total, 113 patients were recruited. There were no significant differences between the treatment subgroups in either the SF-36 or Skindex-29 results. However, for the GHQ, there were large differences in QOL scores between patients scoring > 4 points (GHQ+) and those scoring < 4 points (GHQ-), especially for the more 'physical' components of QOL. The overall observed proportion of GHQ+ patients was 33.6%.
  
  
  CONCLUSIONS
  We found no significant differences in QOL impairment between the treatment subgroups; however, we observed a strong association between psychiatric morbidity and poorer QOL within each of the treatment groups. This should be of concern for dermatologists, as psychiatric morbidity is associated with poor treatment adherence and dissatisfaction with care.
authors: Health Services Research Unit, IDI-IRCCS, Rome, Italy. aparad@tin.it
authors: A
authors: A
authors: Paradisi
authors: G
authors: G
authors: Cianchini
authors: F
authors: F
authors: Lupi
authors: C
authors: C
authors: Di Pietro
authors: F
authors: F
authors: Sampogna
authors: B
authors: B
authors: Didona
authors: C
authors: C
authors: Pagliarello
authors: S
authors: S
authors: Tabolli
authors: D
authors: D
authors: Abeni
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010392:Pemphigus / Q000188:drug therapy / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires
chemical_list: D000305:Adrenal Cortex Hormones; D007166:Immunosuppressive Agents