Factors associated with dermatology life quality index scores in children with chronic skin disorders: A cross-sectional analytical study.

Abstract

Objective: To identify factors associated with dermatology specific quality of life impairment in children with chronic skin conditions. Study Design: Cross Sectional Analytical study. Setting: Pediatric Dermatology Clinic in Multan. Period: January–December 2025. Methods: Enrolled 381 children aged 4–18 years with physician confirmed chronic dermatoses Participants completed age-appropriate quality of life instruments (CDLQI for ages 4–15; DLQI for ages 16–18) alongside assessments of demographics, clinical characteristics, bullying exposure, and anxiety symptoms. Multivariate linear regression identified independent predictors of quality of life scores. Results: Mean CDLQI/DLQI score was 8.5 ± 5.3, with 52.8% experiencing moderate-to-severe impairment (scores ≥6). Atopic dermatitis predominated (47.8%) and demonstrated highest mean impairment (9.9 ± 5.5). Multivariate analysis revealed seven independent predictors: greater body surface area involvement (β=0.27, p<0.001), female sex (β=1.35, p<0.001), lower socioeconomic status (β=2.38, p<0.001), atopic dermatitis diagnosis (β=1.84, p<0.001), bullying exposure (β=2.61, p<0.001), anxiety symptoms (β=1.92, p<0.001), and longer disease duration (β=0.03, p=0.005). The final model explained 49% of variance in quality of life scores. Conclusion: Quality of life impairment reflects complex interactions between clinical severity, psychosocial stressors and socioeconomic context. Holistic management must integrate dermatological treatment with anti-bullying initiatives and mental health support.