Interpretation of skindex-29 scores: cutoffs for mild, moderate, and severe impairment of health-related quality of life

cytes via transcriptional control of the Akt1 The authors state no conflict of interest.
Jiang YJ, Lu B, Kim P et al. (2008) PPAR and LXR We thank Ms Aoyanagi for her technical assistance.
This work was supported in part by a grant-in-aid Mitsutake S, Suzuki C, Akiyama M et al. (2010) from the Ministry of Education, Science, Sports and glucosylceramide accumulation during kerati- Culture of Japan (Kiban A 23249058: to MA), a grantfrom the Ministry of Health, Labor and Welfare of nocyte differentiation. J Dermatol Sci 60:128–9 Japan (Health and Labor Sciences Research Grants; Moskowitz DG, Fowler AJ, Heyman MB et al.
Research on Intractable Disease: H22-177: to MA), and a grant-in-aid from the Japan Society for the failure in children with ichthyosis: an evalua- Promotion of Science Fellows (to TY).
tion of cutaneous ultrastructure, epidermalpermeability barrier function, and energy Ganglioside loss promotes survival primarily without phosphoinositide 3-OH kinase sig-naling. J Invest Dermatol 119:107–17 significantly higher than that from wild- Thrash BR, Menges CW, Pierce RH et al. (2006) Sapporo, Japan; 2Department of Dermatology,Nagoya University Graduate School of AKT1 provides an essential survival signal required for differentiation and stratification Translational Pathology, Hokkaido University of primary human keratinocytes. J Biol Chem Graduate School of Medicine, Sapporo, Japan Hydrolytic pathway protects against cera- Department of Pathology, Hokkaido UniversityGraduate School of Medicine, Sapporo, Japan mide-induced apoptosis in keratinocytes ex- Wang XQ, Sun P, Paller AS (2001) Inhibition B/Akt signaling: mechanism for ganglioside- Supplementary material is linked to the online induced apoptosis. J Biol Chem 276:44504–11 Wang Z, Coleman DJ, Bajaj G et al. (2011) RXRalpha ablation in epidermal keratinocytes Abe R, Shimizu T, Shibaki A et al. (2003) Toxic tosis, and proliferation of keratinocytes and melanocytes. J Invest Dermatol 131:177–87 syndrome are induced by soluble Fas ligand.
Yanagi T, Akiyama M, Nishihara H et al. (2008) vive during the keratinization process.
Akiyama M, Sugiyama-Nakagiri Y, Sakai K et al.
alveolar collapse and severe fetal skin barrier (2005) Mutations in lipid transporter ABCA12 in harlequin ichthyosis and functional recov- Yanagi T, Akiyama M, Nishihara H et al. (2010) ery by corrective gene transfer. J Clin Invest Self-improvement of keratinocyte differentiation defects during skin maturation in ABCA12- Di-Poi N, Tan NS, Michalik L et al. (2002) deficient harlequin ichthyosis model mice. Am Antiapoptotic role of PPARbeta in keratino- Interpretation of Skindex-29 Scores: Cutoffs for Mild, Moderate,and Severe Impairment of Health-Related Quality of Life Journal of Investigative Dermatology (2011) 131, 1945–1947; published online 19 May 2011 scores correctly. What does a given score really mean? Although there is no standard important challenge is to interpret these approach, several methods exist to facil-itate the interpretation of HRQL scores.
Abbreviation: HRQL, health-related quality of life CAC Prinsen et al.
Interpretation of Skindex-29 Scores Table 1. Skindex-291 cutoff scores for mildly, moderately, and severely impaired HRQL Impact of disease on HRQL for Skindex-29 domain andoverall scores2 Abbreviations: AUC, area under the curve; HRQL, health-related quality of life.
1The domain scores and the overall score are expressed on a 100-point scale, with higher scores indicating a lower level of quality of life.
2The number of patients in each severity category varies, as it largely depends on the required number of responses to the Skindex-29 domains. The numberof patients with mildly impaired HRQL ranged from 144–195; the number of patients with moderately impaired HRQL ranged from 73–104; and the numberof patients with severely impaired HRQL ranged from 49–74.
3AUC: 0.50 indicates chance categorization and 1.00 indicates perfect categorization of a given Skindex-29 score to correctly classify mild, moderate, orsevere impairment of HRQL.
4Cutoff scores and AUC coefficients for severely impaired HRQL as presented in the original article receiver-operating characteristic statis- of effect. In this letter, we will provide Skindex-29 domain score (r ¼ 0.54).
practice, it might be helpful, as a rule of meanings of ‘‘symptoms’’ as worded in ment to measure psychiatric morbidity.
the anchor question and ‘‘symptoms’’ overall scores, with the exception of the 1946 Journal of Investigative Dermatology (2011), Volume 131 Infliximab Infusions for Netherton Syndrome The authors state no conflict of interest.
Chren MM (2010) Interpretation of quality-of-life The original study was performed in nine derma-tology outpatient clinics in the Netherlands.
Guyatt GH, Osoba D, Wu AW et al. (2002) Methods We thank all the dermatologists whose collabora- to explain the clinical significance of health status measures. Mayo Clin Proc 77:371–83 Chren MM, Lasek RJ, Flocke SA et al. (1997a) Nijsten T, Sampogna F, Abeni D (2009) Categori- zation of Skindex-29 scores using mixture capability of a refined version of Skindex,a quality-of-life instrument for patients Prinsen CA, Lindeboom R, Sprangers MA et al.
(2010) Health-related quality of life assess- Amsterdam, The Netherlands and 2Department Chren MM, Lasek RJ, Quinn LM et al. (1997b) ment in dermatology: interpretation of Skin- of Clinical Epidemiology, Biostatistics and dex-29 scores using patient-based anchors.
of a generic and a disease-specific instrument Infliximab Infusions for Netherton Syndrome: SustainedClinical Improvement Correlates with a Reduction ofThymic Stromal Lymphopoietin Levels in the Skin Journal of Investigative Dermatology (2011) 131, 1947–1950; published online 9 June 2011 for an extensive pruritic dermatitis that tration and contributing to atopy in NS.
titis–like lesions and elevated serum IgE could reduce skin inflammation in NS.
12, thus confirming the diagnosis of NS.
the institutional ethical requirements of the superficial dermis, whereas thedensity of mast cells was similar to thatin normal skin. Because TNF-a is Abbreviations: LEKT1, lymphoepithelial Kazal-type-related inhibitor; NS, Netherton syndrome; SPINK5, serine protease inhibitor Kazal-type 5; Th2, T helper type 2; TNF-a, tumor necrosis factor-a; TSLP, thymic


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