Chronic skin conditions and life trajectories: development and validation of "Dermatology Long-Term Life Impact Measure (DLLIM)"

Authors

Jonathan I. Silverberg, Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia.
Charbel Skayem, Université Paris Saclay, Assistance Publique-Hôpitaux de Paris (AP-HP), Paris, France.
Ann'Laure Demessant Flavigny, La Roche-Posay Laboratoire Dermatological Beauty in Paris, France.
Caroline Le Floc'h, La Roche-Posay Laboratoire Dermatological Beauty in Paris, France.
Stéphanie Methand, Association Française de l'Eczéma, Redon, France.
Wendy Smith Begolka, National Eczema Association (Novato, CA, USA).
África Luca Smith, Asociación de Afectados por la Dermatitis Atópica, (AADA), Spain.
Shulamit Burstein, The Israeli Association for Atopic Dermatitis.
Claire Della Vedova, Biostatistician, Manosque, France.
Emmanuel Chamorey, Department of Epidemiology, Biostatistics, and Health Data, Centre Antoine Lacassagne, Université Cote d'Azur, Nice, France.
Delphine Kerob, Patients Priority, European Market Maintenance Assessment, Paris, France.
Charles Taieb, Société Française des Sciences Humaines de la Peau, [SFSHP], Maison de la dermatologie, Paris, France. Electronic address: Charles.taieb@emma.clinic.
Khaled Ezzedine, Hôpital Henri Mondor and Université Paris-Est Créteil, EpiDermE-Epidemiology in Dermatology and Evaluation of Therapeutics, Creteil, France.

Document Type

Journal Article

Publication Date

8-25-2025

Journal

Journal of the American Academy of Dermatology

DOI

10.1016/j.jaad.2025.08.042

Keywords

Chronic skin conditions; life decisions; measure; score

Abstract

BACKGROUND: To date, tools evaluating the impact of skin diseases on quality of life have investigated short-term impact, overlooking the long-term effects on important life decisions. OBJECTIVE: to create and validate the "Dermatology Long-Term Life Impact Measure (DLLIM)" questionnaire, that assesses the impact of six chronic inflammatory skin diseases on an individual's life decisions METHODS: Following COSMIN guidelines, we developed and validated DLLIM through item refinement and psychometric testing in a sample of 16,727 patients with chronic skin diseases. Factorial and construct validity were assessed, alongside internal consistency using Cronbach's alpha. Cross-cultural validation was performed in 10 languages. RESULTS: Eleven items covering education, work, and emotional life demonstrated strong uni-dimensionality (CFI: 0.96, RMSEA: 0.071) and high internal consistency (Cronbach's α = 0.966). DLLIM scores correlated strongly with stigmatization scores (PUSH-D), supporting construct validity. LIMITS: The majority of patients had atopic dermatitis (n=15,223), which might limit generalizability. CONCLUSION: DLLIM is a valid, reliable instrument for measuring the long-term impact of chronic skin diseases on life decisions. It fills a gap in dermatological quality-of-life assessment and supports patient-centered care.

APA Citation

Silverberg, Jonathan I.; Skayem, Charbel; Flavigny, Ann'Laure Demessant; Le Floc'h, Caroline; Methand, Stéphanie; Begolka, Wendy Smith; Smith, África Luca; Burstein, Shulamit; Della Vedova, Claire; Chamorey, Emmanuel; Kerob, Delphine; Taieb, Charles; and Ezzedine, Khaled, "Chronic skin conditions and life trajectories: development and validation of "Dermatology Long-Term Life Impact Measure (DLLIM)"" (2025). GW Authored Works. Paper 7719.
https://hsrc.himmelfarb.gwu.edu/gwhpubs/7719

Department

Dermatology