Improvement in the cutaneous disease activity of patients with dermatomyositis is associated with a better quality of life

BackgroundCutaneous dermatomyositis (DM) disease activity is associated with decreased quality of life. ObjectivesTo 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. MethodsPatients 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 2months 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. ResultsThe 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<001), functioning (P<001) and symptoms (P<001). The change in VAS score between responders and nonresponders was also significant for itch (P=001) and pain (P=004). 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 5years of a diagnosis of DM. ConclusionsThis is the first study to demonstrate that the quality of life of patients with DM improved as their cutaneous disease activity decreased.