The extent and nature of disability in different urticarial conditions

Chronic forms of urticaria are common. often adversely impacting on quality of life. No formal studies have assessed the extent and nature of disabili ty in different types of urticaria. The Dermatology Life Quality Index (DLQ I) is a simple and validated 10-item questionnaire designed to measure and compare disability in different skin conditions. In this study, we aimed to assess the disability in different urticarial groups using the DLQI, allow ing comparison with previously published DLQI scores in common skin disease s. The DLQI was administered to 170 consecutive patients attending a specia list urticaria clinic over a 4-month period. Consistent with previous studi es using the DLQI, mean scores were not influenced by gender or age. Patien ts with chronic idiopathic urticaria without a concurrent physical urticari a (n = 47) suffered moderate quality of life impairment (mean +/- SD DLQI 2 5 +/- 24%). In comparison, patients with chronic idiopathic urticaria with concurrent delayed pressure urticaria (DPU) (n = 26) suffered significantly higher quality of life impairment (mean +/- SD DLQI 43 +/- 23%, 95% confid ence interval for difference 7-29%). Disability in this group was greatest in the dimensions of work/study, symptoms/feelings and leisure. Subjects wi th another form of physical urticaria, cholinergic urticaria, also endured high levels of disability (n=9, mean +/- SD DLQI 50 +/- 34%). From our urti caria study group, we have shown that subjects with DPU and cholinergic urt icaria endure the most quality of life impairment. The mean DLQI scores dem onstrated in these groups are comparable with those previously seen in seve re atopic dermatitis out-patients (60%) and higher than those seen in out-p atients with psoriasis (29.7%), acne (24.3%) and vitiligo (16.1%).