Quality of life assessment in non-melanoma skin cancers and comparison of the quality of life between psoriasis and vitiligo patients

Objective: Skin malignancies are the most frequent cancers in humans. Despite the increase in incidence of non-melanoma skin cancers, deaths are relatively rare. The goal of treatment is to prevent the recurrence and to increase the quality of life (QOL). The quality of life and the cost of treatment are becoming more important treatment goals as nowadays the non-melanoma skin cancers are rarely life-threatening. Small number of studies assessed the quality of life scales in non-melanoma skin cancers (basal cell carcinoma and squamous cell carcinoma) in the literature, however the combination of quality of life scales that we used to compare QOL is not present. In this study, we aim to compare the quality of life of non-melanoma skin cancers with the quality of life in disorders, such as psoriasis and vitiligo which were shown to affect the quality of life seriously.Method: The study group consists of a total of 150 patients (50 patients with clinically and / or histopathologically diagnosed non-melanoma skin cancer, 50 patients with psoriasis and 50 patients with vitiligo) who were evaluated in Celal Bayar University Medical Faculty, Dermatology Clinic and were aged 18 and above. EORTC QLQ-C30, DLQI, and WHOQOL-Bref quality of life scales were applied to non-melanoma skin cancer patients, and DLQI and WHOQOL-Bref quality of life scales applied to psoriasis and vitiligo patients. The socio-demographic status, disease severity assessment (Psoriasis Area and Severity Index - PASI), and other health problems were also assessed by a questionnaire. The age, gender, marital status, occupation, education level, disease type, locations of the lesions, duration of disease, and accompanying systemic diseases (co-morbidities) were recorded.Results: In our study, quality of life was compared with the DLQI scale (a QOL quastionnare specific to dermatologic diseases) and with the WHOQOL-BREF TR scale (a QOL quastionnare of general health) among the non-melanoma skin cancer, psoriasis and vitiligo groups. Quality of life was statistically different among the non-melanoma skin cancer, psoriasis and vitiligo groups. Quality of life was similar in terms of total DLQI score, symptoms and feelings subscale score, and work and school subscale score between non-melanoma skin cancer and psoriasis patients, and also QOL was statistically more impaired in these groups than vitiligo patients. QOL was more impaired in psoriasis patients than vitiligo patients in daily activities and personal relations subscales. In leisure and treatment dimensions, QOL was most impaired in psoriasis patients, followed by non-melanoma skin cancer and was least impaired in vitiligo patients. QOL was similar between non-melanoma skin cancer and psoriasis patients but was more impaired in these groups than vitiligo patients in physical and social domains in WHOQOL-BREF TR questionnaire. QOL was more impaired in non-melanoma skin cancer group than vitiligo patients in Environmental-TR (+ National social pressure) domain. QOL scores was not statistically different among groups in Psychological domain.Conclusion: The EORTC QLQ-C30 (QOL questionnaire in cancer patients), Dermatology Life Quality Index (DLQI), WHOQOL-BREF TR questionnaires were used to compare the QOL among the groups in our study. We found no difference between QOL domains of any questionnaire among SCC and BCC patients and BCC subtypes. The current questionnaires are not specific to this population. Our study and previous studies indicate the need for a disease-specific quality of life questionnaires. In our study, we found that QOL was statistically different among non-melanoma skin cancer, psoriasis and vitiligo groups. Obtaining the similar QOL scores in all groups by DLQI and the WHOQOL-BREF-TR questionnaire may indicate that WHOQOL-BREF TR scale (a scale to assess QOL of general health) can be used in conjunction with DLQI (a specific questionnaire to assess QOL in dermatologic diseases) scale to assess QOL in dermatologic diseases.