title: Quality of life in South African Black women with alopecia: a pilot study.
abstract: BACKGROUND
  Alopecia has been shown to have a significant impact on quality of life (QoL), particularly in women. However, there are no data for African populations. This study was conducted to pilot an original questionnaire and a model-based methodology to measure QoL and its determinants in a sample of South African Black women of African ancestry with alopecia.
  
  
  METHODS
  Fifty participants aged 21-79 years were randomly chosen from patients presenting to dermatologists with alopecia. We used an original questionnaire consisting of 24 items grouped into those assessing the respective impacts of subjective symptoms, objective signs, and relationship issues, measured on a four-level scale. These were then combined using component-based structural equation modeling to return a QoL index (QLI) and to rank the factors contributing to this.
  
  
  RESULTS
  On a scale ranging from 0 (high QoL) to 100 (severely decreased QoL), we found a mean QLI of 67.7. The negative impact of alopecia on QoL was higher in younger patients than older patients. The factors with the highest impact were those relating to the subjective experience of alopecia and self-image (56.3%), followed by those relevant to relationships and interaction with other people (34.8%). The presence of objective symptoms and signs such as pruritus was of minor importance (8.9%).
  
  
  CONCLUSIONS
  Although not a life-threatening condition, alopecia may seriously impair QoL, particularly by inducing anxiety and reducing self-esteem among African women. Healthcare practitioners should be mindful of this and intervene appropriately to mitigate these effects.
authors.affiliation: Department of Dermatology, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Ncoza C
authors.initials: NC
authors.lastname: Dlova
authors.affiliation: Section of Clinical, Allergological and Venereological Dermatology, Department of Clinical Medicine and Surgery, University of Naples Federico II, Naples, Italy.
authors.forename: Gabriella
authors.initials: G
authors.lastname: Fabbrocini
authors.affiliation: Department of Economical and Statistical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Lauro
authors.affiliation: Department of Economical and Statistical Sciences, University of Naples Federico II, Naples, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Spano
authors.affiliation: Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA.
authors.forename: Antonella
authors.initials: A
authors.lastname: Tosti
authors.affiliation: School of Clinical Medicine, Nelson R. Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa.
authors.forename: Richard H
authors.initials: RH
authors.lastname: Hift
mesh_terms: D000328:Adult; D000368:Aged; D000505:Alopecia / Q000175:diagnosis / Q000208:ethnology* / Q000523:psychology*; D001007:Anxiety / Q000208:ethnology / Q000503:physiopathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007398:Interpersonal Relations; D008875:Middle Aged; D010865:Pilot Projects; D011788:Quality of Life; D012189:Retrospective Studies; D018570:Risk Assessment; D012649:Self Concept; D012720:Severity of Illness Index; D013019:South Africa; D011795:Surveys and Questionnaires; D014505:Urban Population; D055815:Young Adult