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          Vitiligo is an important skin disease that can alter individual self-image and thus have major impact on the quality of life.


          The objective of this study was to translate and to test the reliability and validity of the 10-item Dermatology Life Quality Index (DLQI) questionnaire in Tunisian vitiliginous patients.


          Using a standard “forward-backward” translation procedure, the English language version of the questionnaire was translated into Persian (the Iranian official language) by two bilinguals. Seventy patients with vitiligo attending the Department of Dermatology, Regional Hospital, Medenine, Tunisia, were enrolled in this study. The reliability and internal consistency of the questionnaire were assessed by Cronbach's α coefficient and Spearman's correlation, respectively. Validity was performed using convergent validity.


          In all, 70 people entered into the study. The mean age of respondents was 28.3 (SD=11.09) years. Scores on the DLQI ranged from 0 to 24 (mean ± SD, 7.05 ± 5.13). Reliability analysis showed satisfactory result (Cronbach's α coefficient=0.77). There were no statistically significant differences between daily activity (DA) and personal relationship (PR) scale mean scores in generalized versus focal-segmental involvement in sufferers ( P = 0.056, P = 0.053, respectively). There were also strong differences between the mean scores of the PR scale with the involvement of covered only and covered/uncovered areas ( P = 0.016) that was statistically significant in the second group.


          The study findings showed that the Tunisian version of the DLQI questionnaire has a good structural characteristic and is a reliable and valid instrument that can be used for measuring the effects of vitiligo on quality of life.

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          Most cited references 18

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          Dermatology Life Quality Index (DLQI)--a simple practical measure for routine clinical use.

          A simple practical questionnaire technique for routine clinical use, the Dermatology Life Quality Index (DLQI) is described. One hundred and twenty patients with different skin diseases were asked about the impact of their disease and its treatment on their lives; a questionnaire, the DLQI, was developed based on their answers. The DLQI was then completed by 200 consecutive new patients attending a dermatology clinic. This study confirmed that atopic eczema, psoriasis and generalized pruritus have a greater impact on quality of life than acne, basal cell carcinomas and viral warts. The DLQI was also completed by 100 healthy volunteers; their mean score was very low (1.6%, s.d. 3.5) compared with the mean score for the dermatology patients (24.2%, s.d. 20.9). The reliability of the DLQI was examined in 53 patients using a 1 week test-retest method and reliability was found to be high (gamma s = 0.99).
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            Translating health status questionnaires and evaluating their quality: the IQOLA Project approach. International Quality of Life Assessment.

            This article describes the methods adopted by the International Quality of Life Assessment (IQOLA) project to translate the SF-36 Health Survey. Translation methods included the production of forward and backward translations, use of difficulty and quality ratings, pilot testing, and cross-cultural comparison of the translation work. Experience to date suggests that the SF-36 can be adapted for use in other countries with relatively minor changes to the content of the form, providing support for the use of these translations in multinational clinical trials and other studies. The most difficult items to translate were physical functioning items, which used examples of activities and distances that are not common outside of the United States; items that used colloquial expressions such as pep or blue; and the social functioning items. Quality ratings were uniformly high across countries. While the IQOLA approach to translation and validation was developed for use with the SF-36, it is applicable to other translation efforts.
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              Psychiatric morbidity in vitiligo: prevalence and correlates in India.

               I Kaur,  Gopal Gupta,  S Handa (2002)
              Vitiligo, a common pigmentary disorder, is recognized to be associated with a high psychiatric morbidity, yet compared to other dermatological disorders like leprosy, psoriasis, etc., it has not been subjected to detailed evaluation of its psychological consequences. The data from the developing countries on this aspect in particular is meager. One hundred and thirteen cases with vitiligo were evaluated along with 55 healthy controls comparable for sociodemographic profile and matched on attitude to appearance scale. Clinical details, impact of illness, associated dysfunction and psychological morbidity were additionally assessed. Twenty-eight patients with vitiligo were found to have psychiatric morbidity, a clinic prevalence rate of 25% (95% confidence interval 20.3-29.3%). The majority of the cases had a diagnosis of adjustment disorder. Psychiatric morbidity was significantly correlated with dysfunction arising out of illness. Vitiligo is associated with high psychiatric morbidity. There is a need to develop cross-cultural database on psychosocial aspects and psychiatric morbidity associated with vitiligo.

                Author and article information

                Indian J Dermatol
                Indian Journal of Dermatology
                Medknow Publications (India )
                Oct-Dec 2009
                : 54
                : 4
                : 330-333
                From the Department of Physiology, Unité de Recherche sur les Composés antioxydants, Stress Oxydant, Eléments Traces et Maladies Métaboliques, Ecole Supérieure des Sciences et Techniques de la Santé de Tunis, Tunisia.
                [1 ] From the Department of Service d'anatomie-pathologie, d'Embryologie et de Foetopathologie, CHU-Centre de Maternité et de Néonatologie de Tunis, Tunisia.
                Author notes
                Address for correspondence: Dr. Akrem Jalel, Ecole Supérieure des Sciences et Techniques de la Santé de Tunis. BP 176 Bab-Souika 1006 Tunis, Tunisia. E-mail: akrem_jalel@
                © Indian Journal of Dermatology

                This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                Original Article


                psychologic side effects, vitiligo, tunisian patient


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