Improvement in the Cutaneous Disease Activity of Patients with Dermatomyositis is Associated with a Better Quality of Life

Overview

Journal Br J Dermatol

Publisher Oxford University Press

Specialty Dermatology

Date 2014 Jun 10

PMID 24909747

Citations 12

Authors

E S Robinson

R Feng

J Okawa

V P Werth

Affiliations

Soon will be listed here.

Abstract

Background: Cutaneous dermatomyositis (DM) disease activity is associated with decreased quality of life.

Objectives: To assess if an improvement in quality of life, as measured by the Skindex-29 and patient-reported itch and pain on a 10-point visual analogue scale (VAS), correlated with an improvement in cutaneous DM disease activity.

Methods: Patients with a completed cutaneous DM disease area and severity index [Cutaneous Dermatomyositis Disease Area and Severity Index (CDASI)] at two visits separated by at least 2 months were classified into responder (n = 15) and nonresponder (n = 30) groups according to the point change in the CDASI activity scores between visits. Responders had at least a four-point improvement in CDASI activity, indicating clinically relevant improvement.

Results: The change from baseline to the follow-up visit of the Skindex-29 subscale scores for the responders vs. the nonresponders were significantly different for emotions (P < 0·01), functioning (P < 0·01) and symptoms (P < 0·01). The change in VAS score between responders and nonresponders was also significant for itch (P = 0·01) and pain (P = 0·04). There was no significant difference between the groups in terms of disease subtype, sex, race, age, treatment for DM, smoking history or a history of malignancy within 5 years of a diagnosis of DM.

Conclusions: This is the first study to demonstrate that the quality of life of patients with DM improved as their cutaneous disease activity decreased.

Citing Articles

Development and Evaluation of the Dermatomyositis Outcomes for Muscle and Skin as an Outcome Measure in Dermatomyositis Clinical Trials.

Pandya R, Dan J, Kleitsch J, Lim D, White B, Werth V JID Innov. 2025; 5(2):100337.

PMID: 39877684 PMC: 11773231. DOI: 10.1016/j.xjidi.2024.100337.

Safety and Efficacy of Lenabasum, a Cannabinoid Receptor Type 2 Agonist, in Patients with Dermatomyositis with Refractory Skin Disease: A Randomized Clinical Trial.

Werth V, Hejazi E, Pena S, Haber J, Zeidi M, Reddy N J Invest Dermatol. 2022; 142(10):2651-2659.e1.

PMID: 35490744 PMC: 10226779. DOI: 10.1016/j.jid.2022.03.029.

Itch: Epidemiology, clinical presentation, and diagnostic workup.

Roh Y, Choi J, Sutaria N, Kwatra S J Am Acad Dermatol. 2021; 86(1):1-14.

PMID: 34428534 PMC: 8678917. DOI: 10.1016/j.jaad.2021.07.076.

Pruritus in autoimmune connective tissue diseases.

Kim H Ann Transl Med. 2021; 9(5):441.

PMID: 33842662 PMC: 8033328. DOI: 10.21037/atm-20-4894.

Functioning in adult patients with idiopathic inflammatory myopathy: Exploring the role of environmental factors using focus groups.

Armadans-Tremolosa I, Guilera G, Las Heras M, Castrechini A, Selva-OCallaghan A PLoS One. 2021; 16(2):e0244959.

PMID: 33571213 PMC: 7877601. DOI: 10.1371/journal.pone.0244959.

References

Harris P, Taylor R, Thielke R, Payne J, Gonzalez N, Conde J . Research electronic data capture (REDCap)--a metadata-driven methodology and workflow process for providing translational research informatics support. J Biomed Inform. 2008; 42(2):377-81. PMC: 2700030. DOI: 10.1016/j.jbi.2008.08.010. View

Chang A, Ghazi E, Okawa J, Werth V . Quality of life differences between responders and nonresponders in the treatment of cutaneous lupus erythematosus. JAMA Dermatol. 2013; 149(1):104-6. PMC: 3928008. DOI: 10.1001/2013.jamadermatol.467. View

Moreland L, Schiff M, Baumgartner S, Tindall E, Fleischmann R, Bulpitt K . Etanercept therapy in rheumatoid arthritis. A randomized, controlled trial. Ann Intern Med. 1999; 130(6):478-86. DOI: 10.7326/0003-4819-130-6-199903160-00004. View

Chren M, Lasek R, Quinn L, Mostow E, Zyzanski S . Skindex, a quality-of-life measure for patients with skin disease: reliability, validity, and responsiveness. J Invest Dermatol. 1996; 107(5):707-13. DOI: 10.1111/1523-1747.ep12365600. View

Hundley J, Carroll C, Lang W, Snively B, Yosipovitch G, Feldman S . Cutaneous symptoms of dermatomyositis significantly impact patients' quality of life. J Am Acad Dermatol. 2006; 54(2):217-20. DOI: 10.1016/j.jaad.2004.12.015. View

Boden J, Fergusson D, Horwood L . Cigarette smoking and depression: tests of causal linkages using a longitudinal birth cohort. Br J Psychiatry. 2010; 196(6):440-6. DOI: 10.1192/bjp.bp.109.065912. View

Goreshi R, Chock M, Foering K, Feng R, Okawa J, Rose M . Quality of life in dermatomyositis. J Am Acad Dermatol. 2011; 65(6):1107-16. PMC: 3189436. DOI: 10.1016/j.jaad.2010.10.016. View

Drouet B, Le Loet X, Vittecoq O, Nouvet G, Genevois A, Lauret P . A study of long-term survival, functional outcome and quality of life in patients with polymyositis or dermatomyositis. Rev Rhum Engl Ed. 1996; 63(5):321-30. View

Chren M, Lasek R, Quinn L, Covinsky K . Convergent and discriminant validity of a generic and a disease-specific instrument to measure quality of life in patients with skin disease. J Invest Dermatol. 1997; 108(1):103-7. DOI: 10.1111/1523-1747.ep12285650. View

10.

Taylor G, McNeill A, Girling A, Farley A, Lindson-Hawley N, Aveyard P . Change in mental health after smoking cessation: systematic review and meta-analysis. BMJ. 2014; 348:g1151. PMC: 3923980. DOI: 10.1136/bmj.g1151. View

11.

Anyanwu C, Fiorentino D, Chung L, Dzuong C, Wang Y, Okawa J . Validation of the Cutaneous Dermatomyositis Disease Area and Severity Index: characterizing disease severity and assessing responsiveness to clinical change. Br J Dermatol. 2015; 173(4):969-74. PMC: 4878996. DOI: 10.1111/bjd.13915. View

12.

Piette E, Foering K, Chang A, Okawa J, Have T, Feng R . Impact of smoking in cutaneous lupus erythematosus. Arch Dermatol. 2011; 148(3):317-22. PMC: 3309110. DOI: 10.1001/archdermatol.2011.342. View

13.

Lipsky P, van der Heijde D, St Clair E, Furst D, Breedveld F, Kalden J . Infliximab and methotrexate in the treatment of rheumatoid arthritis. Anti-Tumor Necrosis Factor Trial in Rheumatoid Arthritis with Concomitant Therapy Study Group. N Engl J Med. 2000; 343(22):1594-602. DOI: 10.1056/NEJM200011303432202. View

14.

Yassaee M, Fiorentino D, Okawa J, Taylor L, Coley C, Troxel A . Modification of the cutaneous dermatomyositis disease area and severity index, an outcome instrument. Br J Dermatol. 2009; 162(3):669-73. PMC: 2852630. DOI: 10.1111/j.1365-2133.2009.09521.x. View

15.

Klein R, Bangert C, Costner M, Connolly M, Tanikawa A, Okawa J . Comparison of the reliability and validity of outcome instruments for cutaneous dermatomyositis. Br J Dermatol. 2008; 159(4):887-94. PMC: 2829655. DOI: 10.1111/j.1365-2133.2008.08711.x. View

16.

Shirani Z, Kucenic M, Carroll C, Fleischer Jr A, Feldman S, Yosipovitch G . Pruritus in adult dermatomyositis. Clin Exp Dermatol. 2004; 29(3):273-6. DOI: 10.1111/j.1365-2230.2004.01510.x. View