Akne vulgaris hastalarının değerlendirilmesi için hangi yaşam kalite ölçeği kullanılmalıdır? CADI ya da DYKİ? Bir prospektif çalışma

Öz

Amaç: Akne vulgaris, sık görülen, kişinin yaşam kalitesini ve sosyal hayatını olumsuz yönde etkileyen dermatolojik bir hastalıktır. Klinik çalışmalarda, akne vulgarisin hastaların yaşam kalitesini olumsuz yönde etkileyen en sık hastalıklardan olduğu görülmektedir.  Dermatolojik Yaşam Kalite İndeksi (DYKİ); dermatolojik hastalıklar için yaygın olarak kullanılan bir indeks iken, Cardiff Akne Kısıtlılık İndeksi (CADI) akneye özgü değerlendirme skalası olarak kullanılmaktadır. Bu çalışmanın amacı, akne hastalarında hangi ölçeğin daha uygun ve pratik olduğunu tespit etmek ve iki skala arasındaki farkları değerlendirmektir.

Yöntemler: Çalışmamızda Aralık 2015- Kasım 2016 tarihleri arasında Dermatoloji polikliniğine başvuran ve akne tanısı alan toplam 273 hastanın akne skorları Global Akne Skorlama Sistemi (GAGS) (aralık 0 ile 44 arası) ile belirlenip ardından DYKİ (aralık 0 ile 30 arası) ve CADI skorları (aralık 0 ile 20 arası) ile yaşam kalitesi belirlendi.

Sonuçlar: Hastaların GAGS skoru ortalaması 20,3, CADI skoru ortalaması 6,1 iken DYKİ ortalaması 6,0 idi. DYKİ ile CADI skorları arasında pozitif korelasyon mevcuttu (r=0,639, p<0,001). Akne lezyonlarının dağılımı ile yaşam kalite ölçekleri arasındaki ilişki değerlendirildiğinde; alın lokalizasyonu olan grupta CADI skoru, alın lokalizasyonu olmayan gruptan anlamlı olarak daha yüksekti (p=0,012). Sırt üst lokalizasyonu olan grupta CADI ve DYKİ skoru sırt lokalizasyonu olmayan gruptan anlamlı olarak daha yüksekti (sırasıyla p=0,001ve p= 0,017).

Tartışma: Çalışmamızda DYKİ ve CADI yaşam ölçeklerinin, akne tanılı olgularda yaşam kalitesini değerlendirmede birbirine üstünlükleri olmadığı ancak yüz yerleşimli akne vakalarında yaşam kalitesinin etkilenme düzeyinin CADI skoru ile daha net belirlenebileceği gözlemlendi.

Anahtar Kelimeler

• Akne vulgaris,Cardiff Akne Kısıtlılık İndeksi,Dermatolojik Yaşam Kalite İndeksi,yaşam kalitesi

Which quality of life scale should be used to evaluate acne vulgaris patients? CADI or DLQI? A prospective study

Abstract

Aim: Acne vulgaris is one of the most common diseases that affects quality of life. While the Dermatology Life Quality Index (DLQI) is the most frequently used life quality index for dermatologic disorders, the Cardiff Acne Disability Index (CADI) is an acne-spesific quality of life scale. The aim of this study was to determine which scale should be more appropriate and practical to evaluate the quality of life in acne patients and to compare the differences between two scales.

Methods: Acne scores of 273 patients who were admitted to the dermatology outpatient clinic between December 2015 and November 2016 were determined by the Global Acne Grading System (GAGS) (range 0 to 44). The DLQI (range 0 to 30) and CADI scores (range 0 to 20) were calculated to evaluate the effect of patients' quality of life.

Results: The mean GAGS score of the patients was 20.3, and the mean of CADI score was 6.1, while the mean of DLQI was 6.0. There was a significant positive correlation between total GAGS score and CADI and DLQI (r=0.639, p<0.001). When the relationship between the distribution of acne lesions and quality of life scales was evaluated; CADI score was significantly higher in the forehead localization group than in the non-forehead localization group (p=0.012), and the CADI and DLQI scores were higher in the upper back group than the group without back localization (p=0.001and p= 0.017 respectively).

Conclusion: In our study, it was observed that the DLQI and CADI scales were not superior to each other in evaluating the quality of life in patients with acne. Besides, we think that the effect of quality of life on facial acne cases can be determined more clearly with CADI scale. 

Keywords

• quality of life,Acne,Cardiff Acne Disability Index,Dermatology Life Quality Index,quality of life

Kaynakça

1. 1. Ogedegbe EE, Henshaw EB. Severity and impact of acne vulgaris on the quality of life of adolescents in Nigeria. Clin Cosmet Investig Dermatol. 2014;7:329-34. 2. Hazarika N, Archana M. The Psychosocial Impact of Acne Vulgaris. Indian JDermatol. 2016;61:515-20.
2. 3. World Health Organization. Division of Mental Health and Prevention of Substance Abuse. (‎1997)‎. WHOQOL : measuring quality of life. World Health Organization. Available from https://apps.who.int/iris/handle/10665/63482 4. Barnes LE, Levender MM, Fleischer AB Jr, Feldman SR. Quality of life measures for acne patients. Dermatol Clin. 2012;30:293-300. 5. Doshi A, Zaheer A, Stiller MJ. A comparison of current acne grading systemsand proposal of a novel system. Int J Dermatol. 1997;36:416-8. 6. Dréno B. Assessing quality of life in patients with acne vulgaris:implications for treatment. Am J Clin Dermatol. 2006;7:99-106.
3. 7. Grando LR, Horn R, Cunha VT, Cestari TF. Translation, cultural adaptation and validation for Brazilian Portuguese of the Cardiff Acne Disability Indexinstrument. An Bras Dermatol. 2016;91:180-6.
4. 8. Mulder MM, Sigurdsson V, van Zuuren EJ, Klaassen EJ, Faber JA, de Wit JB, van Vloten WA. Psychosocial impact of acne vulgaris. evaluation of the relation between a change in clinical acne severity and psychosocial state. Dermatology.2001;203:124-30.
5. 9. Fried RG, Wechsler A. Psychological problems in the acne patient. Dermatol Ther. 2006;19:237-40. 10. Ghaderi R, Saadatjoo A, Ghaderi F. Evaluating of life quality in patients with acne vulgaris using generic and specific questionnaires. Dermatol Res Pract. 2013;2013:108624.
6. 11. Jankovic S, Vukicevic J, Djordjevic S, Jankovic J, Marinkovic J, Basra MK. The Cardiff Acne Disability Index (CADI): linguistic and cultural validation in Serbian. Qual Life Res. 2013;22:161-66. 12. Law MP, Chuh AA, Lee A. Validation of a Chinese version of the Cardiff Acne Disability Index. Hong Kong Med J. 2009;15:12-7. 13. Ozturkcan S, Ermertcan AT, Eser E, Sahin MT. Cross validation of the Turkish version of dermatology life quality index. Int J Dermatol. 2006;45:13007. 14. Durai PC, Nair DG. Acne vulgaris and quality of life among young adults in South India. Indian J Dermatol. 2015;60:33-40.
7. 15. Salman A, Kurt E, Topcuoglu V, Demircay Z. Social Anxiety and Quality of Life in Vitiligo and Acne Patients with Facial Involvement: A Cross-Sectional Controlled Study. Am J Clin Dermatol. 2016;17:305-11. 16. Gupta A, Sharma YK, Dash KN, Chaudhari ND, Jethani S. Quality of life in acne vulgaris: Relationship to clinical severity and demographic data. Indian J Dermatol Venereol Leprol. 2016;82:292-7. 17. Yap FB. Cardiff acne disability index in Sarawak, Malaysia. Ann Dermatol. 2012;24:158-61. 18. Safizadeh H, Shamsi-Meymandy S, Naeimi A. Quality of life in Iranian patients with acne. Dermatol Res Pract. 2012;2012:571516.
8. 19. Hanisah A, Omar K, Shah SA. Prevalence of acne and its impact on the quality of life in school-aged adolescents in Malaysia. J Prim Health Care. 2009;1:20–5. 20. Law MPM, Chuh AAT, Lee A, Molinari N. Acne prevalence and beyond: acne disability and its predictive factors among Chinese late adolescents in Hong Kong. Clin Exp Dermatol. 2010;35:16–21.

9. 21. Yazici K, Baz K, Yazici AE, Köktürk A, Tot S, Demirseren D, et al. Disease-specific quality of life is associated with anxiety and depression in patients with acne. J Eur Acad Dermatol Venereol.. 2004;18:435–9. 22. El-Hamd MA, Nada EEA, Moustafa MA, Mahboob-Allah RA. Prevalence of acnevulgaris and its impact of the quality of life among secondary school-agedadolescents in Sohag Province, Upper Egypt. J Cosmet Dermatol. 2017;1:370-3. 23. Ilgen E, Derya A. There is no correlation between acne severity and AQOLS/DLQI scores. J Dermatol. 2005;32:705-10. 24. Hazarika N, Rajaprabha RK. Assessment of Life Quality Index Among Patients with Acne Vulgaris in a Suburban Population. Indian J Dermatol. 2016;61:163-8. 25. Awad SM, Morsy H, Sayed AA, Mohamed NA, Ezzat GM, Noaman MM. Oxidative stress and psychiatric morbidity in patients with facial acne. J Cosmet Dermatol. 2018;17:203-8. 26. Basak PY, Ergin S. Effects of acne vulgaris on quality of life. Türkderm,2000;34:107-9. 27. El-Khateeb EA, Khafagy NH, Abd Elaziz KM, Shedid AM. Acne vulgaris: prevalence, beliefs, patients' attitudes, severity and impact on quality of life in Egypt. Public Health. 2014;128:576-8. 28. Lukaviciute L, Navickas P, Navickas A, Grigaitiene J, Ganceviciene R, Zouboulis CC. Quality of life, anxiety prevalence, depression symptomatology and suicidal ideation among acne patients in Lithuania. J Eur Acad Dermatol Venereol. 2017;31:1900-6.