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Peer-reviewedCC BY 4.0Journal of Clinical Medicine

DLQIad: A New Quality-of-Life Questionnaire for Patients with Atopic Dermatitis

  • Ersilia Tolino1,2
  • Antonio Di Guardo3
  • Umberto Gallo1,2
  • Nicoletta Bernardini1,2
  • Ilaria Proietti1,2
  • Nevena Skroza1,2
  1. 1Unit of Dermatology ‘Daniele Innocenzi’, Fiorini Hospital, 04019 Terracina, Italy
  2. 2Dermatology Unit “Daniele Innocenzi”, Department of Medical-Surgical Sciences and Biotechnologies, “Sapienza” University of Rome, Polo Pontino, 04100 Latina, Italy
  3. 3Istituto Dermopatico dell'Immacolata (IDI-IRCCS), Dermatological Research Hospital, 00167 Rome, Italy
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Abstract

Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease that substantially impairs health-related quality of life (HRQoL). The Dermatology Life Quality Index (DLQI) is widely used, but it is a generic dermatology instrument and may not capture the full patient-reported burden of AD. This study developed an exploratory AD-specific questionnaire (DLQIad), evaluated its internal consistency, and compared its responsiveness with that of the DLQI in patients receiving dupilumab. Methods: In this real-life, single-centre observational study, 102 adults with moderate-to-severe AD completed the DLQIad and DLQI and underwent Eczema Area and Severity Index (EASI) assessment before and after 16 weeks of dupilumab treatment. Pre–post differences were evaluated using Wilcoxon signed-rank tests. Internal consistency was assessed using Cronbach’s alpha. Responsiveness was quantified using the standardised response mean (SRM) and the standardised mean-change effect size, and paired patient-level bootstrap resampling was used to compare the DLQIad and DLQI. Results: Mean EASI decreased from 27.84 to 5.96, mean DLQI from 15.76 to 2.35, and mean DLQIad from 44.24 to 8.19 (all p < 0.001). Cronbach’s alpha was 0.945 at baseline and 0.929 at week 16. The DLQIad showed an SRM of 2.31 compared with 1.89 for the DLQI; the paired difference was 0.421 (BCa 95% CI, 0.134–0.750; p = 0.009). The corresponding difference in standardised mean-change effect size was 0.362 (BCa 95% CI, −0.014–0.762; p = 0.065). Changes in EASI were significantly associated with changes in both patient-reported instruments, without a significant difference between their standardised regression coefficients. Conclusions: The DLQIad demonstrated high internal consistency and preliminary evidence of responsiveness in this selected cohort. Its apparent advantage over the DLQI was dependent on the responsiveness metric used. Structural validity, test–retest reliability, interpretability, and score thresholds require evaluation in independent multicentre samples before clinical implementation.

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Cite

BibTeXRIS
BibTeX
@article{tolino2026dlqiad,
  title = {{DLQIad: A New Quality-of-Life Questionnaire for Patients with Atopic Dermatitis}},
  author = {Ersilia Tolino and Antonio Di Guardo and Umberto Gallo and Nicoletta Bernardini and Ilaria Proietti and Nevena Skroza},
  journal = {Journal of Clinical Medicine},
  year = {2026},
  month = nov,
  doi = {10.3390/jcm15218695},
  url = {https://www.mdpi.com/2077-0383/15/21/8695},
  note = {CC BY 4.0},
}
RIS
TY  - JOUR
TI  - DLQIad: A New Quality-of-Life Questionnaire for Patients with Atopic Dermatitis
AU  - Ersilia Tolino
AU  - Antonio Di Guardo
AU  - Umberto Gallo
AU  - Nicoletta Bernardini
AU  - Ilaria Proietti
AU  - Nevena Skroza
PY  - 2026
DA  - 2026/11/07
JO  - Journal of Clinical Medicine
DO  - 10.3390/jcm15218695
UR  - https://www.mdpi.com/2077-0383/15/21/8695
AB  - Background/Objectives: Atopic dermatitis (AD) is a chronic inflammatory skin disease that substantially impairs health-related quality of life (HRQoL). The Dermatology Life Quality Index (DLQI) is widely used, but it is a generic dermatology instrument and may not capture the full patient-reported burden of AD. This study developed an exploratory AD-specific questionnaire (DLQIad), evaluated its internal consistency, and compared its responsiveness with that of the DLQI in patients receiving dupilumab. Methods: In this real-life, single-centre observational study, 102 adults with moderate-to-severe AD completed the DLQIad and DLQI and underwent Eczema Area and Severity Index (EASI) assessment before and after 16 weeks of dupilumab treatment. Pre–post differences were evaluated using Wilcoxon signed-rank tests. Internal consistency was assessed using Cronbach’s alpha. Responsiveness was quantified using the standardised response mean (SRM) and the standardised mean-change effect size, and paired patient-level bootstrap resampling was used to compare the DLQIad and DLQI. Results: Mean EASI decreased from 27.84 to 5.96, mean DLQI from 15.76 to 2.35, and mean DLQIad from 44.24 to 8.19 (all p < 0.001). Cronbach’s alpha was 0.945 at baseline and 0.929 at week 16. The DLQIad showed an SRM of 2.31 compared with 1.89 for the DLQI; the paired difference was 0.421 (BCa 95% CI, 0.134–0.750; p = 0.009). The corresponding difference in standardised mean-change effect size was 0.362 (BCa 95% CI, −0.014–0.762; p = 0.065). Changes in EASI were significantly associated with changes in both patient-reported instruments, without a significant difference between their standardised regression coefficients. Conclusions: The DLQIad demonstrated high internal consistency and preliminary evidence of responsiveness in this selected cohort. Its apparent advantage over the DLQI was dependent on the responsiveness metric used. Structural validity, test–retest reliability, interpretability, and score thresholds require evaluation in independent multicentre samples before clinical implementation.
SN  - 2077-0383
ER  -