Quality of Life in FFA: Severity of Disease Does not Correlate with Quality of Life

17 % of FFA Patients from Spain Had Moderate to Severe Impairment in Quality of Life.

Saceda-Corralo et al from Spain studied health related quality of life in 82 female patients with FFA. The authors used 3 scales to better understand that impact of FFA on health. They used the the Dermatology Life Quality Index (DLQI), the Hospital Anxiety and Depression Scale (HADS), and the Revised Illness Perception Questionnaire (IPQ-R) to assess impact of the disease.

A Word About the DLQI

DLQI is an approved 10-item self-reported measure of HRQOL in patients with dermatological conditions. Higher scores (total range 0–30) reflect a greater impairment in HRQOL. The questions are classified under 6 headings items:

1) symptoms and feelings (questions 1- 2),

2) daily activities (questions 3- 4)

3) leisure (questions 5- 6)

4) work and school (question 7),

5), and personal relationships (questions 8- 9)

6) treatment (question10)

Scores range from 0 to 30. DLQI scores 0-1 = no affect at all, 2-5 = low effect, 6-10 = moderate effect, 11-20 = high effect and DLQI score of 21-30 = extreme  

In this study by Saceda-Corralo et al from the median total DLQI score was 2 with range, 0-22. The DLQI scoring showed 42 % had no impairment and 42 % had mild impairment. 12 % had moderate and 5 % had severe impairment. Regarding HADS, the mean levels of psychological distress were low (HADS total score, 5.8, but 19% and 6.3% of the patients had moderate to severe anxiety and depression symptoms, respectively. It should be noted that a HADS score of 0 to 7 is normal.

Scores on Revised Illness Perception Questionnaire IPQ-R questionnaire indicated that patients perceived FFA as a chronic disease  with an unpredictable course,. The women considered that their alopecia had significant consequences on their lives

Overall, the study did not find any association with severity of the alopecia and quality of life.   A negative correlation between the grade of severity and views on personal control of the disease was also detected (r = −0.34, P = .008). Patients with more severe disease felt they had less control. In addition, patients with FFA who presented with trichodynia had a higher impairment of HRQOL (χ2 = 0.508, P = .04);  

This is an interesting and helpful study which documents information which has not been well studied regarding health related quality of life in patient with FFA. Overall, about 1 in 6 patients with FFA are significantly affected by the disease. A proportion of patients had depression and anxiety and these too need to be addressed.

REFERENCE

Saceda-Corralo D et al. Health-Related Quality of Life in Patients With Frontal Fibrosing Alopecia. JAMA Dermatol. 2018 Apr 1;154(4):479-480.