Therapeutic agents may decrease quality of life in patients with immunobullous dermatoses

Quality of life is impaired with negative psychological health outcomes in patients with immunobullous dermatoses, and systemic corticosteroids may increase these risks, according to a poster presentation.

Patients with immunobullous dermatoses such as bullous pemphigoid, pemphigus vulgaris and pemphigus foliaceus were administered the Dermatology Life Quality Index (DLQI) and the General Health Questionnaire-12 (GHQ-12) in a pilot study. Each patient was analyzed by treatment through chart review, according to the poster presented at the American Academy of Dermatology virtual meeting

Those with GHQ-12 scores higher than 4 were defined as “positive cases” with likely comorbid psychiatric conditions. DLQI scores 2 to 5 were identified as having a small effect on patients’ lives, 6 to 10 as a moderate effect, and above 11 as a very or extremely large effect.

Of 26 patients, 50% with bullous pemphigoid and 57% with pemphigus vulgaris or pemphigus foliaceus showed GHQ-positivity, with those currently or previously receiving adjuvant therapy of steroid-sparing immunosuppressants more likely to be GHQ-positive.

Small or moderate effects on quality of life were reported in patients with latent disease, while those with worsening lesions had a moderate effect. Those who received oral corticosteroids or higher doses of corticosteroids were more likely to have worse quality of life scores.

“Systemic corticosteroids and immunomodulatory agents may increase risk for impaired QOL and negative psychological health outcomes,” the authors wrote. “Treating the skin should include a goal for improved mental health in this population, and mental health counseling should be readily available to patients.”