Article

Combination Therapy for Patients with Vitiligo Evaluated with the DLQI

Author(s):

Combined therapies such as ultraviolet light and tab methotrexate were deemed effective in the management of vitiligo.

Utilizing the Dermatology Life Quality Index (DLQI), a team of investigators in Uzbekistan evaluated the effectiveness of combination therapy on patients with vitiligo.

One such treatment, ultraviolet B (UVB) rays of 311 nm, decreased the index by 88.5% when combined with tab methotrexate. The value of DLQI decreased by 91.5% as well.

In their study, investigators led by Maxmudov Farxad Axmedovich, MD, Bukhara State Medical Institute, noted that focusing on a patient’s quality of life was an “important entity” in the management of vitiligo, and that relevant supportive group-based consultations and therapies were suitable methods for the management of the disease.

They referenced the increased interest in the overall and psychosocial QoL of patients with vitiligo. Several previous studies had reported meta-analyses of depression and anxiety associated with the disease.

However, investigators noted that broad QoL instruments had been used in many of the previous studies, which they believed might not have reflected the burdens of vitiligo.

As such, investigators initiated the present study by examining patients with the definition of the DLQI.

The Methods

A total of 60 patients were included in the study and were divided between 2 separate groups.

Each patient was required to answer questions via a 10-point questionnaire before and after treatment.

The questionnaire addressed various aspects of a patient’s life, including professional, household, sexual, social, and personal norms. The questionnaire would determine the degree of influence of vitiligo in the individual’s life.

For each question, 4 variant answers were offered, each of which was rated from 0 to 3 points.

In the end, 0-1 point would indicate “no influence on the patient’s life”, while 21-30 points would state that “the disease has an extremely strong influence on the life of the patient”.

The Findings

Investigators reported that the mean DLQI value was 11.4± 2.07and 11.9 ± 2.03points, which corresponded to the strong influence of disease on the life of the patient.

The average value of the index decreased to 2.03 ± 0.15 points, and secondly to 1.72 ± 0.27, after the methods of combination therapy were applied.

Additionally, statistically significant differences between indicators were revealed before and after treatment (11.4 ± 2.07 versus 2.03 ± 0.15 and 11.9 ± 2.03 versus 1.72 ± 0.27p <0.05)

Results of treatment with UVB rays of 311 nm resulted in the index decreasing by 9 times (88.5%) when treating with a combined method using tab methotrexate.

Investigators noted that the average value of DLQI in both groups did not differ between male and female patients.

Overall, the utilization of the DLQI instrument indicated that combined therapy had positive implications regarding the burden of vitiligo in affected patients.

“Such dynamics of indicators was found in full compliance with the dynamics of regeneration of clinical manifestations in patients,” the team wrote. “Objective data and a survey of patients showed the advantage of a combined therapy, which made it possible to significantly reduce the total dose of radiation what is of importance for the remote side effects.”

The study, “Evaluation of the Quality of Life of Vitiligo Patients by the Effectiveness of Combination Therapy Using the Dermatology Life Quality Index (DLQI),” was published online in Web of Scientist: International Scientific Research Journal.

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