Klinik Araştırma
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Erken Evre Mikozis Fungoides Hastalarında Psikolojik Belirtiler ve Yaşam Kalitesinin Değerlendirilmesi: Bir Vaka-Kontrol Çalışması

Yıl 2025, Cilt: 47 Sayı: 1, 95 - 101, 17.01.2025
https://doi.org/10.20515/otd.1578873

Öz

Mikozis fungoides (MF) en sık görülen kutanöz T hücreli lenfoma türüdür. Bu çalışma erken evre MF hastalarında psikolojik belirtiler ve sağlıkla ilişkili yaşam kalitesini ölçmek ve sonuçları kontrollerle karşılaştırmak amacıyla tasarlanmıştır. Çalışmaya erken evre MF tanılı 40 hasta ve yaş ve cinsiyete uygun 40 sağlıklı kontrol dahil edildi. Tüm katılımcıların sosyodemografik özellikleri kaydedildi ve depresyon, anksiyete ve stres düzeylerini ölçmek için Depresyon, Anksiyete ve Stres Ölçeği-21 (DASÖ-21) uygulandı. Ayrıca, MF hastalarında yaşam kalitesini değerlendirmek için Skindex-29 uygulandı. MF'li hasta ve kontrol grubu arasında DASS-21 alt ölçek puanları ve toplam puanlar açısından anlamlı bir fark saptanmadı. Skindex-29'un semptom ve duygu alt ölçek puanları kadın MF hastalarında istatistiksel olarak daha yüksek bulundu. Skindex-29'a göre ileri yaş MF hastalarının daha kötü semptomları ve işlevsel bozuklukları bulunmaktaydı. DASS-21 ölçeği toplam puanları MF hastalarında tüm Skindex-29 alt ölçek puanlarıyla pozitif korelasyon gösterdi. Sonuç olarak erken evre MF'te yaşam kalitesi ileri yaş ve kadın hastalarda olumsuz olarak etkilenebilmektedir. Depresyon, anksiyete ve stres düzeyleri yüksek hastalarda sağlıkla ilişkili yaşam kalitesinin daha fazla etkilendiği görüldü. MF hastalarının psikolojik sağlıklarının iyileştirilmesiyle yaşam kaliteleri artırılabilir.

Etik Beyan

Çalışmamızın yürütülebilmesi için Eskişehir Osmangazi Üniversitesi Girişimsel Olmayan Klinik Araştırmalar Etik Kurulundan onay alınmıştır.

Kaynakça

  • 1. Willemze R, Cerroni L, Kempf W, Berti E, Facchetti F, Swerdlow SH, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood. 2019:18;133:1703-14.
  • 2. Larocca C, Kupper T. Mycosis Fungoides and Sézary Syndrome: An Update. Hematol Oncol Clin North Am. 2019;33:103-120.
  • 3. Zinzani PL, Ferreri AJ, Cerroni L. Mycosis fungoides. Crit Rev Oncol Hematol. 2008;65:172-82.
  • 4. Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood. 2007;110:1713-22.
  • 5. Hodak E, Lessin S, Friedland R, Freud T, David M, Pavlovsky L, et al. New insights into associated co-morbidities in patients with cutaneous T cell lymphoma (mycosis fungoides). Acta Derm Venereol. 2013;93:451-5.
  • 6. Demierre MF, Kim YH, Zackheim HS. Prognosis, clinical outcomes and quality of life issues in cutaneous T-cell lymphoma. Hematol Oncol Clin North Am. 2003;17:1485-1507.
  • 7. Ottevanger R, van Beugen S, Evers AWM, Willemze R, Vermeer MH, Quint KD. Quality of life in patients with Mycosis Fungoides and Sézary Syndrome: a systematic review of the literature. J Eur Acad Dermatol Venereol. 2021;35:2377-87.
  • 8. Engin B, Kecici AS, Uzun AO, Yalcin M. Psychiatric comorbidity, depression, and anxiety levels and quality of life of the patients with mycosis fungoides. Dermatol Ther. 2020;33:e13922.
  • 9. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335-43.
  • 10. Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. JCBPR. 2018;7:19-30.
  • 11. Chren MM, Lasek RJ, Quinn LM, Mostow EN, Zyzanski SJ. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol. 1996;107:707-13.
  • 12. Aksu AE, Urer MS, Sabuncu I, Saracoglu ZN, Chren MM. Turkish version of Skindex-29. Int J Dermatol. 2007;46(4):350-5.
  • 13. Namli MN, Gokcay H, Tas B, Balcioglu YH, Sagaltici E, Belli H. Association of clinical features and systemic immune inflammation index with psychological distress in acne vulgaris. Dusunen Adam J Psychiatr Neurol Sci. 2022;35:174-180.
  • 14. Chag J, Javadekar A, Mukherjee SS, Chaudhury S, Saldanha D. Psychiatric Co-Morbidy and Quality of Life in Patients with Psoriasis in a Tertiary Care Hospital. J Int Med Sci Acad. 2022;35:337-43.
  • 15. Iocca F, Burlando M, Angelo NL, Ragucci F, Pugi D, Parodi A, et al. Sexual functioning in patients with psoriasis: the role of body dissatisfaction and cognitive biases toward sexuality. J Sex Marital Ther. 2024;50:439-55.
  • 16. Sampogna F, Frontani M, Baliva G, Lombardo GA, Alvetreti G, Di Pietro C, et al. Quality of life and psychological distress in patients with cutaneous lymphoma. Br J Dermatol. 2009;160:815-22.
  • 17. Demierre MF, Gan S, Jones J, Miller DR. Significant impact of cutaneous T-cell lymphoma on patients’ quality of life: results of a 2005 National cutaneous lymphoma foundation survey. Cancer. 2006;107:2504-11.
  • 18. Eder J, Kammerstätter M, Erhart F, Mairhofer-Muri D, Trautinger F. Illness Perception in Primary Cutaneous T-cell Lymphomas: What Patients Believe About Their Disease. Acta Derm Venereol. 2016;96:381-5.
  • 19. Molloy K, Jonak C, Woei-A-Jin FJSH, Guenova E, Busschots AM, Bervoets A, et al. Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study. Br J Dermatol. 2020;182:770-9.
  • 20. Herbosa CM, Semenov YR, Rosenberg AR, Mehta-Shah N, Musiek AC. Clinical severity measures and quality-of-life burden in patients with mycosis fungoides and Sezary syndrome: comparison of generic and dermatology-specific instruments. J Eur Acad Dermatol Venereol. 2020;34: 995-1003.
  • 21. Porkert S, Lehner-Baumgartner E, Valencak J, Knobler R, Riedl E, Jonak C. Patients' Illness Perception as a Tool to Improve Individual Disease Management in Primary Cutaneous Lymphomas. Acta Derm Venereol. 2018;98:240-5.
  • 22. Ortiz Romero PL, Kim YH, Molloy K, Quaglino P, Scarisbrick J, Thornton S, et al. Health-related quality of life in cutaneous T-cell lymphoma: A post hoc analysis of a phase 3 trial in mycosis fungoides and Sézary syndrome. J Eur Acad Dermatol Venereol. 2024 Sep 24.
  • 23. Obradors M, Blanch C, Comellas M, Figueras M, Lizan L. Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Quality of Life Research. 2016;25(11):2739-54.
  • 24. Holm JG, Agner T, Clausen ML, Thomsen SF. Quality of life and disease severity in patients with atopic dermatitis. J Eur Acad Dermatol Venereol. 2016;30:1760-7.
  • 25. Hedayat K, Karbakhsh M, Ghiasi M, Goodarzi A, Fakour Y, Akbari Z, et al. Quality of life in patients with vitiligo: a cross-sectional study based on Vitiligo Quality of Life index (VitiQoL). Health Qual Life Outcomes. 2016;14:86.
  • 26. Sarker SJ, Smith SK, Chowdhury K, Ganz PA, Zimmerman S, Gribben J, et al. Comparison of the impact of cancer between British and US long-term non-Hodgkin lymphoma survivors. Support Care Cancer. 2017;25:739-48.
  • 27. Ottevanger R, van Beugen S, Evers AWM, Willemze R, Vermeer MH, Quint KD. Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator. JAAD Int. 2022;9:57-64.
  • 28. Demierre MF, Ferzli P, Miller D. Measuring HRQOL in patients with cutaneous T-cell lymphoma undergoing therapy with oral bexarotene and extracorporeal photopheresis. Arch Dermatol. 2007;143(5):659-61.
  • 29. Holahan HM, Farah RS, Fitz S, Mott SL, Ferguson NN, McKillip J, et al. Health-related quality of life in patients with cutaneous T-cell lymphoma? Int J Dermatol. 2018;57:1314-19.
  • 30. Jensen RE, Arora NK, Bellizzi KM, Rowland JH, Hamilton AS, Aziz NM. Health-related quality of life among survivors of aggressive non-Hodgkin lymphoma. Cancer. 2013;119:672-680.
  • 31. Kim SH, Kim IR, Kim SH, Lee S, Ok O, Kim WS. Health-related quality of life in Korean lymphoma survivors compared with the general population. Ann Hematol. 2014;93:1531-1540.
  • 32. Smith SK, Mayer DK, Zimmerman S, Williams CS, Benecha H, Ganz PA, et al. Quality of life among long-term survivors of non-Hodgkin lymphoma: a follow-up study. J Clin Oncol. 2013;31:272-9.

Evaluation of Psychological Symptoms and Quality of Life in Patients with Early-Stage Mycosis Fungoides: A Case-Control Study

Yıl 2025, Cilt: 47 Sayı: 1, 95 - 101, 17.01.2025
https://doi.org/10.20515/otd.1578873

Öz

Mycosis fungoides (MF) is the most common type of cutaneous T-cell lymphoma. This study was designed to measure psychological symptoms and health-related quality of life in patients with early-stage MF and compare the results with controls. Forty patients with early-stage MF and 40 age- and gender-matched healthy controls were included in the study. The sociodemographic characteristics of all participants were recorded and Depression, Anxiety and Stress Scale-21 (DASS-21) was administered to measure depression, anxiety and stress levels. Additionally, Skindex-29 was applied to assess the quality of life in MF patients. No significant difference was detected between patient and control groups of MF regarding DASS-21 subscales scores and the total scores. Both symptom and emotion subscale scores of Skindex-29 were found to be statistically higher in female MF patients. Older MF patients had worse symptoms and functional impairment according to Skindex-29. The DASS-21 total scores were positively correlated with all Skindex-29 subscale scores in MF patients. In conclusion, this study demonstrated that quality of life in early-stage MF may be negatively affected in elderly and female patients. Health-related quality of life was more affected in patients with increased levels of depression, anxiety and stress. The quality of life of MF patients can be increased by improving their psychological health.

Kaynakça

  • 1. Willemze R, Cerroni L, Kempf W, Berti E, Facchetti F, Swerdlow SH, et al. The 2018 update of the WHO-EORTC classification for primary cutaneous lymphomas. Blood. 2019:18;133:1703-14.
  • 2. Larocca C, Kupper T. Mycosis Fungoides and Sézary Syndrome: An Update. Hematol Oncol Clin North Am. 2019;33:103-120.
  • 3. Zinzani PL, Ferreri AJ, Cerroni L. Mycosis fungoides. Crit Rev Oncol Hematol. 2008;65:172-82.
  • 4. Olsen E, Vonderheid E, Pimpinelli N, Willemze R, Kim Y, Knobler R, et al. Revisions to the staging and classification of mycosis fungoides and Sezary syndrome: a proposal of the International Society for Cutaneous Lymphomas (ISCL) and the cutaneous lymphoma task force of the European Organization of Research and Treatment of Cancer (EORTC). Blood. 2007;110:1713-22.
  • 5. Hodak E, Lessin S, Friedland R, Freud T, David M, Pavlovsky L, et al. New insights into associated co-morbidities in patients with cutaneous T cell lymphoma (mycosis fungoides). Acta Derm Venereol. 2013;93:451-5.
  • 6. Demierre MF, Kim YH, Zackheim HS. Prognosis, clinical outcomes and quality of life issues in cutaneous T-cell lymphoma. Hematol Oncol Clin North Am. 2003;17:1485-1507.
  • 7. Ottevanger R, van Beugen S, Evers AWM, Willemze R, Vermeer MH, Quint KD. Quality of life in patients with Mycosis Fungoides and Sézary Syndrome: a systematic review of the literature. J Eur Acad Dermatol Venereol. 2021;35:2377-87.
  • 8. Engin B, Kecici AS, Uzun AO, Yalcin M. Psychiatric comorbidity, depression, and anxiety levels and quality of life of the patients with mycosis fungoides. Dermatol Ther. 2020;33:e13922.
  • 9. Lovibond PF, Lovibond SH. The structure of negative emotional states: Comparison of the Depression Anxiety Stress Scales (DASS) with the Beck Depression and Anxiety Inventories. Behav Res Ther. 1995;33:335-43.
  • 10. Saricam H. The psychometric properties of Turkish version of Depression Anxiety Stress Scale-21 (DASS-21) in health control and clinical samples. JCBPR. 2018;7:19-30.
  • 11. Chren MM, Lasek RJ, Quinn LM, Mostow EN, Zyzanski SJ. Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol. 1996;107:707-13.
  • 12. Aksu AE, Urer MS, Sabuncu I, Saracoglu ZN, Chren MM. Turkish version of Skindex-29. Int J Dermatol. 2007;46(4):350-5.
  • 13. Namli MN, Gokcay H, Tas B, Balcioglu YH, Sagaltici E, Belli H. Association of clinical features and systemic immune inflammation index with psychological distress in acne vulgaris. Dusunen Adam J Psychiatr Neurol Sci. 2022;35:174-180.
  • 14. Chag J, Javadekar A, Mukherjee SS, Chaudhury S, Saldanha D. Psychiatric Co-Morbidy and Quality of Life in Patients with Psoriasis in a Tertiary Care Hospital. J Int Med Sci Acad. 2022;35:337-43.
  • 15. Iocca F, Burlando M, Angelo NL, Ragucci F, Pugi D, Parodi A, et al. Sexual functioning in patients with psoriasis: the role of body dissatisfaction and cognitive biases toward sexuality. J Sex Marital Ther. 2024;50:439-55.
  • 16. Sampogna F, Frontani M, Baliva G, Lombardo GA, Alvetreti G, Di Pietro C, et al. Quality of life and psychological distress in patients with cutaneous lymphoma. Br J Dermatol. 2009;160:815-22.
  • 17. Demierre MF, Gan S, Jones J, Miller DR. Significant impact of cutaneous T-cell lymphoma on patients’ quality of life: results of a 2005 National cutaneous lymphoma foundation survey. Cancer. 2006;107:2504-11.
  • 18. Eder J, Kammerstätter M, Erhart F, Mairhofer-Muri D, Trautinger F. Illness Perception in Primary Cutaneous T-cell Lymphomas: What Patients Believe About Their Disease. Acta Derm Venereol. 2016;96:381-5.
  • 19. Molloy K, Jonak C, Woei-A-Jin FJSH, Guenova E, Busschots AM, Bervoets A, et al. Characteristics associated with significantly worse quality of life in mycosis fungoides/Sézary syndrome from the Prospective Cutaneous Lymphoma International Prognostic Index (PROCLIPI) study. Br J Dermatol. 2020;182:770-9.
  • 20. Herbosa CM, Semenov YR, Rosenberg AR, Mehta-Shah N, Musiek AC. Clinical severity measures and quality-of-life burden in patients with mycosis fungoides and Sezary syndrome: comparison of generic and dermatology-specific instruments. J Eur Acad Dermatol Venereol. 2020;34: 995-1003.
  • 21. Porkert S, Lehner-Baumgartner E, Valencak J, Knobler R, Riedl E, Jonak C. Patients' Illness Perception as a Tool to Improve Individual Disease Management in Primary Cutaneous Lymphomas. Acta Derm Venereol. 2018;98:240-5.
  • 22. Ortiz Romero PL, Kim YH, Molloy K, Quaglino P, Scarisbrick J, Thornton S, et al. Health-related quality of life in cutaneous T-cell lymphoma: A post hoc analysis of a phase 3 trial in mycosis fungoides and Sézary syndrome. J Eur Acad Dermatol Venereol. 2024 Sep 24.
  • 23. Obradors M, Blanch C, Comellas M, Figueras M, Lizan L. Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Quality of Life Research. 2016;25(11):2739-54.
  • 24. Holm JG, Agner T, Clausen ML, Thomsen SF. Quality of life and disease severity in patients with atopic dermatitis. J Eur Acad Dermatol Venereol. 2016;30:1760-7.
  • 25. Hedayat K, Karbakhsh M, Ghiasi M, Goodarzi A, Fakour Y, Akbari Z, et al. Quality of life in patients with vitiligo: a cross-sectional study based on Vitiligo Quality of Life index (VitiQoL). Health Qual Life Outcomes. 2016;14:86.
  • 26. Sarker SJ, Smith SK, Chowdhury K, Ganz PA, Zimmerman S, Gribben J, et al. Comparison of the impact of cancer between British and US long-term non-Hodgkin lymphoma survivors. Support Care Cancer. 2017;25:739-48.
  • 27. Ottevanger R, van Beugen S, Evers AWM, Willemze R, Vermeer MH, Quint KD. Itch in patients with cutaneous T-cell lymphoma as a quality of life indicator. JAAD Int. 2022;9:57-64.
  • 28. Demierre MF, Ferzli P, Miller D. Measuring HRQOL in patients with cutaneous T-cell lymphoma undergoing therapy with oral bexarotene and extracorporeal photopheresis. Arch Dermatol. 2007;143(5):659-61.
  • 29. Holahan HM, Farah RS, Fitz S, Mott SL, Ferguson NN, McKillip J, et al. Health-related quality of life in patients with cutaneous T-cell lymphoma? Int J Dermatol. 2018;57:1314-19.
  • 30. Jensen RE, Arora NK, Bellizzi KM, Rowland JH, Hamilton AS, Aziz NM. Health-related quality of life among survivors of aggressive non-Hodgkin lymphoma. Cancer. 2013;119:672-680.
  • 31. Kim SH, Kim IR, Kim SH, Lee S, Ok O, Kim WS. Health-related quality of life in Korean lymphoma survivors compared with the general population. Ann Hematol. 2014;93:1531-1540.
  • 32. Smith SK, Mayer DK, Zimmerman S, Williams CS, Benecha H, Ganz PA, et al. Quality of life among long-term survivors of non-Hodgkin lymphoma: a follow-up study. J Clin Oncol. 2013;31:272-9.
Toplam 32 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Dermatoloji
Bölüm ORİJİNAL MAKALELER / ORIGINAL ARTICLES
Yazarlar

Esra Ağaoğlu 0000-0001-8985-6224

Hanife Merve Akça 0000-0001-8280-7470

Niyazi Kürşat Çayır 0009-0004-0486-3679

Hilal Kaya Erdogan 0000-0002-8172-1920

Ersoy Acer 0000-0002-6041-6636

Yayımlanma Tarihi 17 Ocak 2025
Gönderilme Tarihi 5 Kasım 2024
Kabul Tarihi 30 Aralık 2024
Yayımlandığı Sayı Yıl 2025 Cilt: 47 Sayı: 1

Kaynak Göster

Vancouver Ağaoğlu E, Akça HM, Çayır NK, Kaya Erdogan H, Acer E. Evaluation of Psychological Symptoms and Quality of Life in Patients with Early-Stage Mycosis Fungoides: A Case-Control Study. Osmangazi Tıp Dergisi. 2025;47(1):95-101.


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