Index

DERMATOLOGY LIFE QUALITY INDEX

The aim of this questionnaire is to measure how much your skin problem has affected your life OVER THE LAST WEEK. Please tick one box for each question.

1. Over the last week, how itchy, sore, painful or stinging has your skin been?

1. Over the last week, how itchy, sore, painful or stinging has your skin been?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

2. Over the last week, how embarrassed or self conscious have you been because of your skin?

2. Over the last week, how embarrassed or self conscious have you been because of your skin?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

3. Over the last week, how much has your skin interfered with you going shopping or looking after your home or garden?

3. Over the last week, how much has your skin interfered with you going shopping or looking after your home or garden?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

4. Over the last week, how much has your skin influenced the clothes you wear?

4. Over the last week, how much has your skin influenced the clothes you wear?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

5. Over the last week, how much has your skin affected any social or leisure activities?

5. Over the last week, how much has your skin affected any social or leisure activities?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

6. Over the last week, how much has your skin made it difficult for you to do any sport?

6. Over the last week, how much has your skin made it difficult for you to do any sport?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

7. Over the last week, has your skin prevented you from working or studying?

7. Over the last week, has your skin prevented you from working or studying?

Yes Yes

No No

Not relevant Not relevant

If "No", over the last week how much has your skin been a problem at work or studying?

If "No", over the last week how much has your skin been a problem at work or studying?

A lot A lot

A little A little

Not at all Not at all

8. Over the last week, how much has your skin created problems with your partner or any of your close friends or relatives?

8. Over the last week, how much has your skin created problems with your partner or any of your close friends or relatives?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

9. Over the last week, how much has your skin caused any sexual difficulties?

9. Over the last week, how much has your skin caused any sexual difficulties?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

10. Over the last week, how much of a problem has the treatment for your skin been, for example by making your home messy, or by taking up time?

10. Over the last week, how much of a problem has the treatment for your skin been, for example by making your home messy, or by taking up time?

Very much Very much

A lot A lot

A little A little

Not at all Not at all

Not relevant Not relevant

Done – show results

Your DLQI Score is:

0 – minimal impairment

30 – maximal impairment

0 - 1 = no effect at all on patient’s life

2 - 5 = small effect on patient’s life

6 - 10 = moderate effect on patient’s life

11 - 20 = very large effect on patient’s life

21 - 30 = extremely large effect on patient’s life

Points

Device