Cosmetic camouflage improves health-related quality of life in women with systemic lupus erythematosus and permanent skin damage: A controlled intervention study.

Objective: To investigate the effect of cosmetic camouflage in health-related quality of life (HRQoL) in women with systemic lupus erythematosus (SLE) and permanent facial skin damage. Methods: This is a randomized controlled clinical trial (Universal Trial Number: U1111-1210-2554e) with SLE women from outpatients using ACR/1997 and/or SLICC/2012 criteria, aged over 18 years old, with modified SLEDAI 2k < 4 and permanent facial skin damage, recruited in two tertiary centers to use cosmetic camouflage (n = 36) or no intervention (n = 20). Endpoints were score variations in SLE Quality of Life (SLEQoL) (total and each domain), Dermatology Life Quality Index (DLQI), Rosenberg self-esteem scale and Hospital Anxiety and Depression Scale (HADS), after daily use of cosmetic camouflage for 12 +/−2 weeks (Phase I), "as needed" use of cosmetic camouflage for another 12 +/−2 weeks (Phase II), and during total follow up (24 +/−2 weeks). Univariate and multivariate linear regressions were conducted by protocol analysis. Results: Both groups were similar at baseline regarding age, disease duration, socio-demographic, clinical, laboratory and treatment characteristics. The comparison of score variations between intervention and control groups showed an independent HRQoL improvement in total SLEQoL score after using cosmetic camouflage in Phase I [β −27.56 (CI 95% −47.86 to −7.27) p = 0.009] and total follow up [β −28.04 (CI 95% −48.65 to −7.44) p = 0.09], specifically in mood, self-image and physical functioning domains. Also, there was an improvement in DLQI scores during Phase I [β −7.65 (CI 95% −12.31 to −3.00) p = 0.002] and total follow up [β −8.97(CI95% −12.99 to −4.94) p < 0.001). Scores for depression [β −1.92 (CI 95% −3.67 to −0.16) p = 0.033], anxiety [β −2.87 (CI 95% −5.67 to −0.07] p = 0.045] and self-esteem [β 2.79 (CI 95% 0.13 to 5.46) p = 0.041] improved considering the total follow up. No significant changes occurred in the control group scores. Conclusion: The use of cosmetic camouflage improved the HRQoL in female SLE patients with permanent facial skin damage. [ABSTRACT FROM AUTHOR]