title: Quality of life impact of childhood skin conditions measured using the Children's Dermatology Life Quality Index (CDLQI): a meta-analysis.
abstract: BACKGROUND
  The Children's Dermatology Life Quality Index (CDLQI) is the most widely used instrument for measuring the impact of skin disease on quality of life (QoL) in children.
  
  
  OBJECTIVE
  To provide a meta-analysis of all published QoL scores for a range of childhood skin conditions.
  
  
  METHODS
  Studies using the CDLQI questionnaire to measure QoL in skin conditions were identified by searching Medline and Embase from January 1995 (CDLQI creation) to December 2014. Studies were grouped according to condition and baseline scores were combined using meta-analysis.
  
  
  RESULTS
  Sixty-seven studies using the CDLQI met the inclusion criteria. The overall estimated CDLQI scores for conditions reported more than once were [point estimate (95% confidence interval, CI), number of studies (n), score range]: atopic eczema [8·5 (7·1-9·8), n = 38, 0-29], acne [5·3 (1·9-8·5), n = 5, 0-30], alopecia [3·1 (0-7·7), n = 2, 0-6], molluscum contagiosum [3·5 (0·6-6·7), n = 5, 0-27], psoriasis [8·0 (3·9-12·1), n = 6, 0-29], scabies [9·2 (0·0-20·3), n = 2, 1-26], urticaria [7·1 (0-15·4), n = 2, 0-22], vitiligo [6·5 (0·7-12·2), n = 2, 0-20] and warts [2·9 (0-5·8), n = 4, 0-16]. Overall, the mean effect on QoL [weighted average CDLQI score 4·6 (95% CI 3·9-5·4)] for children with these conditions was small. However, many children were found to experience a very large impact on QoL (34% of children with atopic eczema, 10% with molluscum contagiosum and 1-5% with acne) in studies where the distributions of scores were provided.
  
  
  CONCLUSIONS
  Most skin conditions in children have a 'small' mean effect on QoL. However, the range is large and a significant proportion of children with many common skin conditions will experience a very large effect on quality of life.
authors.affiliation: Institute of Health and Wellbeing, College of Medical Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8RZ, U.K.
authors.forename: J R
authors.initials: JR
authors.lastname: Olsen
authors.affiliation: Department of Psychiatry, Medical Sciences Division, University of Oxford, Oxford, OX3 7JX, U.K.
authors.forename: J
authors.initials: J
authors.lastname: Gallacher
authors.affiliation: Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, U.K.
authors.forename: A Y
authors.initials: AY
authors.lastname: Finlay
authors.affiliation: Department of Dermatology and Academic Wound Healing, Institute of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, CF14 4XN, U.K.
authors.forename: V
authors.initials: V
authors.lastname: Piguet
authors.affiliation: Cochrane Institute of Primary Care and Public Health, School of Medicine, Cardiff University, Cardiff, CF14 4YS, U.K.
authors.forename: N A
authors.initials: NA
authors.lastname: Francis
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D017060:Patient Satisfaction; D011788:Quality of Life; D012720:Severity of Illness Index; D012871:Skin Diseases / Q000523:psychology*; D011795:Surveys and Questionnaires