Introduction

The concept of trying to measure the impact that skin disease has on patients' lives has only gained wide acceptance over the past 10 years. Dermatologists have always, presumably, been aware of the devastating effect that skin disease can have upon the lives of their patients, but historically most publications have focused on the pathology of the skin rather than on the subsequent effect on the patient. This chapter will introduce the reasons why measurement methods are needed, review the major techniques that have been described and detail how they are validated. Some recent research findings will be reviewed and current challenges for further research in this area identified.

What is quality of life?

The concept of what constitutes quality of life (QoL) is controversial (Koller & Lorenz, 2002) and whether it can be meaningfully measured even more so. The following attempt at defining QoL emphasises the difficulties in defining what most people feel they instinctively understand: & ‘Quality of life can be defined as the individual's perception of their position in life, in relation to their goals and to the value-system which they have accepted and incorporated in to their decision making’ (Sartorius, 1993). There is a more limited concept of health-related QoL that is limited to the effects that health or its absence has on life. The World Health Organisation (WHO) has given definitions of and explained how disease can lead to impairment, which leads to disability and which in turn may lead to handicap (WHO, 1980).