title: Improvement in the cutaneous disease activity of patients with dermatomyositis is associated with a better quality of life.
abstract: BACKGROUND
  Cutaneous dermatomyositis (DM) disease activity is associated with decreased quality of life.
  
  
  OBJECTIVE
  To assess if an improvement in quality of life, as measured by the Skindex-29 and patient-reported itch and pain on a 10-point visual analogue scale (VAS), correlated with an improvement in cutaneous DM disease activity.
  
  
  METHODS
  Patients with a completed cutaneous DM disease area and severity index [Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)] at two visits separated by at least 2 months were classified into responder (n = 15) and nonresponder (n = 30) groups according to the point change in the CDASI activity scores between visits. Responders had at least a four-point improvement in CDASI activity, indicating clinically relevant improvement.
  
  
  RESULTS
  The change from baseline to the follow-up visit of the Skindex-29 subscale scores for the responders vs. the nonresponders were significantly different for emotions (P < 0·01), functioning (P < 0·01) and symptoms (P < 0·01). The change in VAS score between responders and nonresponders was also significant for itch (P = 0·01) and pain (P = 0·04). There was no significant difference between the groups in terms of disease subtype, sex, race, age, treatment for DM, smoking history or a history of malignancy within 5 years of a diagnosis of DM.
  
  
  CONCLUSIONS
  This is the first study to demonstrate that the quality of life of patients with DM improved as their cutaneous disease activity decreased.
authors.affiliation: Veteran Affairs Medical Center, Philadelphia, PA, U.S.A.; Department of Dermatology, University of Pennsylvania, 1 Convention Avenue, Philadelphia, PA, 19104, U.S.A.
authors.forename: E S
authors.initials: ES
authors.lastname: Robinson
authors.forename: R
authors.initials: R
authors.lastname: Feng
authors.forename: J
authors.initials: J
authors.lastname: Okawa
authors.forename: V P
authors.initials: VP
authors.lastname: Werth
mesh_terms: D003882:Dermatomyositis / Q000523:psychology* / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000523:psychology; D017060:Patient Satisfaction; D011446:Prospective Studies; D011537:Pruritus / Q000523:psychology; D011788:Quality of Life; D012720:Severity of Illness Index