Health-related quality of life in morphoea

Background Little is known about the health-related quality of life (HRQoL) of patients with morphoea, and previous studies have yielded conflicting results. Objectives To determine the impact of morphoea on HRQoL, and clinical and demographic correlates of HRQoL in adults. Methods This was a cross-sectional survey (n = 73) of the Morphea in Adults and Children cohort. Results Morphoea impairs HRQoL in adults. Patients were most impaired by emotional well-being and concerns that the disease would progress to internal organs. Patients with morphoea had worse skin-specific HRQoL than those with nonmelanoma skin cancer, vitiligo and alopecia (lowest P < 0·01). Participants had significantly worse global HRQoL scores than the general U.S. population for all subscales (all P < 0·01), with the exception of bodily pain. Comorbidity (r = 0·35-0·51, all P < 0·01), and symptoms of pruritus (r = 0·38-0·64, all P < 0·01) and pain (r = 0·46-0·74, all P < 0·01) were associated with impairment in multiple domains of skin-specific and global HRQoL. Physician-based measures of disease severity correlated with patient-reported HRQoL. Conclusions Patients with morphoea experience a negative impact on HRQoL, particularly if symptoms (pruritus and pain) or concerns regarding internal manifestations are present. Providers should be aware of this when evaluating and treating patients. What's already known about this topic? Little is known about health-related quality of life (HRQoL) in morphoea. Existing studies indicate that morphoea has a modest effect on quality of life in children, while studies in adults generally report greater negative impact on quality of life and emotional distress. What does this study add? Disease severity and symptoms, such as pain and itch, are linked with HRQoL. Pruritus reflects disease activity. Individuals with morphoea worry about the impact and progression of their condition. HRQoL issues in morphoea should be addressed. Physicians have the opportunity to intervene with education about the disease and its prognosis.