Quality of life impact of childhood skin conditions measured using the Children's Dermatology Life Quality Index (CDLQI): a meta-analysis

• Published in: British journal of dermatology (1951) Vol. 174; no. 4; pp. 853 - 861
• Main Authors: Olsen, J.R., Gallacher, J., Finlay, A.Y., Piguet, V., Francis, N.A.
• Format: Journal Article
• Language: English
• Published: England Blackwell Publishing Ltd 01.04.2016
• Subjects: Adolescent; Child; Child, Preschool; Humans; Patient Satisfaction; Quality of Life; Severity of Illness Index; Skin Diseases - psychology; Surveys and Questionnaires
• ISSN: 0007-0963; 1365-2133
• DOI: 10.1111/bjd.14361

Summary Background The Children's Dermatology Life Quality Index (CDLQI) is the most widely used instrument for measuring the impact of skin disease on quality of life (QoL) in children. Objectives To provide a meta‐analysis of all published QoL scores for a range of childhood skin conditions. Methods Studies using the CDLQI questionnaire to measure QoL in skin conditions were identified by searching Medline and Embase from January 1995 (CDLQI creation) to December 2014. Studies were grouped according to condition and baseline scores were combined using meta‐analysis. Results Sixty‐seven studies using the CDLQI met the inclusion criteria. The overall estimated CDLQI scores for conditions reported more than once were [point estimate (95% confidence interval, CI), number of studies (n), score range]: atopic eczema [8·5 (7·1–9·8), n = 38, 0–29], acne [5·3 (1·9–8·5), n = 5, 0–30], alopecia [3·1 (0–7·7), n = 2, 0–6], molluscum contagiosum [3·5 (0·6–6·7), n = 5, 0–27], psoriasis [8·0 (3·9–12·1), n = 6, 0–29], scabies [9·2 (0·0–20·3), n = 2, 1–26], urticaria [7·1 (0–15·4), n = 2, 0–22], vitiligo [6·5 (0·7–12·2), n = 2, 0–20] and warts [2·9 (0–5·8), n = 4, 0–16]. Overall, the mean effect on QoL [weighted average CDLQI score 4·6 (95% CI 3·9–5·4)] for children with these conditions was small. However, many children were found to experience a very large impact on QoL (34% of children with atopic eczema, 10% with molluscum contagiosum and 1–5% with acne) in studies where the distributions of scores were provided. Conclusions Most skin conditions in children have a ‘small’ mean effect on QoL. However, the range is large and a significant proportion of children with many common skin conditions will experience a very large effect on quality of life. What's already known about this topic? Skin conditions can impact on a child's quality of life (QoL). QoL measures that inform treatment planning are more likely to be used in clinical practice. What does this study add? Overall, childhood skin conditions have a mean ‘small’ effect on QoL but there is a wide range of severity experienced by individual children. Most skin diseases are associated with a major impact on dermatology‐specific life quality in a small proportion of children. This review provides a guide for clinicians in interpreting the QoL impact of a skin condition and may inform treatment planning. Linked Comment: Prinsen and Apfelbacher. Br J Dermatol 2016; 174:720–721. Plain language summary available online