title: The dermatologic intimacy scale: quantitatively measuring the impact of skin disease on intimacy.
abstract: BACKGROUND
  Patient-reported outcome measures are increasingly utilized in dermatology to assess the impact of skin disease on quality of life. Despite recognition of the influence of skin disease on intimate relationships, an instrument to assess intimacy has not been developed. The objective of this study was to create the dermatologic intimacy scale (DIS) and administer the prototype to a patient population.
  
  
  METHODS
  A group of healthcare providers at the University of California San Francisco created the DIS prototype. A total of 1676 psoriasis patients of an online community were invited to complete a cross-sectional survey including demographic information, DIS, body surface area (BSA) and anatomical involvement.
  
  
  RESULTS
  A total of 1109 patients completed the survey in its entirety. Patients with moderate-to-severe psoriasis (BSA ≥3%) had a higher DIS score overall and for each individual question than patients with mild disease (BSA < 3%; p < .001). Patients with genitalia, nails, face, neck and scalp involvement had higher scores compared to patients without involvement (p < .001).
  
  
  CONCLUSIONS
  Patients with more extensive disease and specific anatomical involvement experience a greater impact on intimacy. Interpretation is limited by patient response rate, as patients with or without intimacy issues may be more or less likely to respond. Further analysis is necessary for validation and interpretation.
authors.affiliation: a Department of Dermatology , University of California San Francisco , San Francisco , CA , USA.|b Chicago Medical School , Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA.
authors.forename: Mona
authors.initials: M
authors.lastname: Malakouti
authors.affiliation: b Chicago Medical School , Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA.|c College of Medicine , University of Arizona , Tucson , AZ , USA.
authors.forename: Gabrielle E
authors.initials: GE
authors.lastname: Brown
authors.affiliation: b Chicago Medical School , Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA.
authors.forename: Argentina
authors.initials: A
authors.lastname: Leon
authors.affiliation: b Chicago Medical School , Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA.
authors.forename: Eva
authors.initials: E
authors.lastname: Wang
authors.affiliation: d Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: April N
authors.initials: AN
authors.lastname: Naegeli
authors.affiliation: d Eli Lilly and Company , Indianapolis , IN , USA.
authors.forename: Emily
authors.initials: E
authors.lastname: Edson-Heredia
authors.affiliation: b Chicago Medical School , Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA.
authors.forename: Ethan
authors.initials: E
authors.lastname: Levin
authors.affiliation: b Chicago Medical School , Rosalind Franklin University of Medicine and Science , North Chicago , IL , USA.
authors.forename: John Y M
authors.initials: JYM
authors.lastname: Koo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000473:pathology / Q000523:psychology*; D011788:Quality of Life; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D055815:Young Adult
keywords: Intimacy; dermatology; patient-reported outcome; psychometric instrument; psychosocial; quality of life; relationships; sexuality; skin disease; stigma