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The DermCLCI-r and DermCLCI-p are two measuring instruments developed to determine the Cumulative Life Course Impairment (CLCI) in skin diseases. The DermCLCI-r instrument determines retrospectively which changes and effects the patients have already experienced due to the disease over their entire disease course. In contrast, DermCLCI-p determines the patient's current situation and thus identifies risk areas in which the patient could experience burdens in the future. This allows the patients to be supported as soon as possible.

Validation of the questionnaires

paper version: yes digital version: no

DermCLCI-r and DermCLCI-p were developed for use in adult patients with psoriasis, atopic dermatitis, and hidradenitis suppurativa. Both questionnaires consist of 30 questions covering all areas of life. Each question is scored on a scale from 0 (not at all) to 3 (very strongly).

In addition, for each question, the DermCLCI-r records whether the burden is still ongoing and whether it was life-changing. Finally, the DermCLCI-r asks about the average burden of the disease at different ages.

Both measurement tools were developed according to the international guidelines for the development of patient-reported outcomes.

Patients with chronic skin diseases experience a wide range of burdens, such as physical, psychological, or emotional impairments. Social life is also often influenced by skin diseases. These situations and burdens can accumulate over lifetime.

The concept of Cumulative Life Course Impairment (CLCI) describes the cumulative burden of the disease over the patient’s life course. These changes over the life course can be irreversible, and thus, triggered by the disease in combination with various inclusion factors, irreversible damage is caused to the patient.

The measurement of cumulative impairment over the life course is of great importance as it allows to assess and understand the overall impact of skin conditions on patients’ lives over time.
The DermCLCI-r can be used to assess the cumulative burden since the onset of the disease, while the DermCLCI-p facilitates early and appropriate (dermatological and psychosocial) treatment and can thus contribute to the prevention of CLCI.

Braren-von Stülpnagel, Catharina C.; Augustin, Matthias; Westphal, Lukas; Sommer, Rachel (2023): Development of Measurement Tools to Assess Cumulative Life Course Impairment (CLCI) in Patients with Chronic Skin Diseases. In: Journal of the European Academy of Dermatology and Venereology : JEADV. DOI: 10.1111/jdv.18977.

Stülpnagel, C. C. von; Augustin, M.; Düpmann, L.; da Silva, N.; Sommer, R. (2021): Mapping risk factors for cumulative life course impairment in patients with chronic skin diseases - a systematic review. In: Journal of the European Academy of Dermatology and Venereology : JEADV 35 (11), S. 2166–2184. DOI: 10.1111/jdv.17348 .

Kimball, A. B.; Gieler, U.; Linder, D.; Sampogna, F.; Warren, R. B.; Augustin, M. (2010): Psoriasis: is the impairment to a patient's life cumulative? In: Journal of the European Academy of Dermatology and Venereology : JEADV 24 (9), S. 989–1004. DOI: 10.1111/j.1468-3083.2010.03705.x .

Augustin, Matthias (2013): Cumulative life course impairment: identifying patients at risk. In: Current problems in dermatology 44, S. 74–81. DOI: 10.1159/000350555.Linder, D. (2011): Cumulative life course impairment: paving the way to an extended life course approach in dermatology. In: The British journal of dermatology 164 Suppl 1, S. v–vi. DOI: 10.1111/j.1365-2133.2011.10321.x .

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What are the eDermCLCI-r and eDermCLCI-p?

How to use the eDermCLCI-r and eDermCLCI-p

The following versions of the eDermCLCI-r and eDermCLCI-p are available

The importance of measuring cumulative life course impairment in skin diseases

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