Quality-of-life impairment in neurofibromatosis type 1 - A cross-sectionalstudy of 128 cases

Background: Neurofibromatosis type I affects quality of life (QoL) through association with severe complications, impact on cosmetic features, and unc ertainty of the effects of the disorder. Objective: To evaluate the impact of the severity and visibility of neurofi bromatosis type 1 on QoL. Design: Monocenter, cross-sectional study. Setting: One French academic dermatological and neurofibromatoses clinic. Patients: A total of 128 adult patients with neurofibromatosis type 1. Main Outcome Measures: Evaluation of severity and visibility using, respect ively, the Riccardi and Ablon scales. Evaluation of skin disease-specific a nd general QoL using, respectively, Skindex-France and SF-36 (Short Form 36 health survey) profiles controlled for sex, age, severity, and visibility. Results: In a multiple regression model controlling for sex, age, and visib ility, visibility remained independently associated with the alteration of 3 aspects of the skin disease-specific QoL (Skindex-France): emotions, phys ical symptoms, and functioning (P=.03, P=.009, and P=.002, respectively). P atients with more severe neurofibromatosis reported more effects on the fol lowing domains of their general health QoL (SF-36): physical function, bodi ly pain, general health perception, and vitality (P=.006, P=.03, P=.01, and P=.04, respectively). Conclusions: Neurofibromatosis type 1 has a significant impact on QoL throu gh alteration of health and appearance. The consequences of visibility and severity from the viewpoint of patients can be evaluated using Skindex and the SF-36, respectively.