OBJECTIVES:

The burden of skin and soft tissue infections (SSTIs) is a multidimensional concept that encompasses psychological, social and financial impact on patients, their families and society. The majority of SSTIs are caused by bacteria and are referred to as acute bacterial skin and skin structure infections (ABSSSIs). Even though the impact of ABSSSIs is greater in children (e.g. schooldays lost), the assessment of quality of life (QoL) is not a widespread practice. The aim of this study was to identify the scales available to assess QoL in population <18 years suffering from different skin conditions.

METHODS:

A systematic literature search was conducted through PubMed database. Three search strategies were designed combining MeSH terms. No time, geography or language limit was determined. All studies were peer-reviewed to assess their inclusion.

RESULTS:

All search strategies resulted in 3,138 studies. After duplicates removal and inclusion criteria application, 373 references were retrieved for full-text analysis, 97 of which reported QoL scales in population <18 years. Most studies were developed in Europe (39% of total).

Generic QoL questionnaires were widely used regardless of the skin condition, mostly DLQI/CDLQI, WHO QoL-26, EQ-5D, Skindex-29, PedsQL4.0 and SF-36. Disease-specific questionnaires were frequently registered for acne, atopic dermatitis/eczema, psoriasis, hemangioma, vitiligo and onychomycosis.

CONCLUSIONS:

QoL assessment is commonly underreported in superficial skin conditions of restricted body surface areas and self-limited processes, like most acute bacterial skin infections. Several disturbances, stigmatization, psychosocial and financial consequences that debilitate patients’ lives and their families may be originated by these skin disorders. Their associated burden in children and resource-limited settings is especially relevant in highly contagious skin diseases, outbreaks and relapses.

Since the evaluation of acute bacterial skin infections impact on QoL has remained a neglected area (ie. Impetigo/folliculitis/abscess/furuncle), further investigation would be advisable to create and implement QoL scoring in these skin conditions.