BACKGROUND: Pemphigus is a rare potentially life-threatening autoimmune disorder clinically characterized by flaccid blisters and painful erosions of the skin and mucous membranes. Very few studies investigated the health-related quality of life (HrQoL) in patients affected by pemphigus, reporting a strong impact on physical and emotional status. OBJECTIVES: To assess HrQoL in patients affected by pemphigus and to develop an appropriate and effective reporting tool for health personnel. METHODS: Patients completed the Skindex-29, GHQ-12, and SF-36 questionnaires. Scores were returned to the clinical staff in a specific standardized format. IKEDA and PGA scores were assessed by a dermatologist to evaluate the severity of the disease. After multiple assessments over time we provided graphics with trends for each patient to be included in the clinical record. RESULTS: For 121 participants (40% males, 56% age>50 years), feed-back forms were provided within 3 hours from data collection. The health status (SF-36) and QoL related to dermatological disease (Skindex- 29) were significantly worse in each dominion for females (SF-36: Physical Dominion: p ≤ 0.001 ¨C Mental Dominion: p ≤ 0.025; Skindex-29: Symptoms: p ≤ 0.01 ¨C Emotions: p ≤ 0.02). 33% of males and 44% of females are at risk of depression and anxiety. Each patient with at least 4 readmissions received a personal plotted figure showing time-trends. The clinical severity scores showed a high, and statistically significant, agreement (k: 0.62), but not with the subjective patient's evaluation. CONCLUSIONS: The routine assessment of HrQoL in patients affected by pemphigus is feasible and can be a very useful outcome measure for clinical studies. The management must also take into account the strong impact the disease has on different aspects of patient's life. Moreover talking about HrQoL-related time-trends after multiple longitudinal assessments seems to be more informative and useful both for patients and health personnel.