PS09 Assessing the impact of vulval skin conditions on adult patients’ psychosocial and psychosexual wellbeing

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Abstract The All Party Parliamentary Group on Skin (APPGS) report highlights the vast psychosocial burden of living with skin disease, and this is particularly true for those with vulval skin conditions. Our study aims to assess and quantify the psychological burden of vulval skin disease, quantify the impact on quality of life including psychosexual wellbeing, and investigate the need for psychology support within a vulval dermatology service. Patients attending a tertiary vulval dermatology clinic were asked to complete a standard Dermatology Life Quality Index (DLQI) and Patient Health Questionnaire-9 (PHQ-9). The patients also responded to questions specifically pertaining to their psychosexual wellbeing, and the general burden of long-term anxiety they experienced as a result of their vulval skin disease. Data were collected over a 2-month period and the results recorded in an Excel spreadsheet by the authors. In total 27 patients were surveyed. The average age of patients included in the study was 57 years (range 24–82). The most common diagnosis was lichen sclerosus (67%), and 63% of patients had more than one diagnosis affecting the vulval skin. The average DLQI score was 10 (range 1–26, with a maximum possible score of 30) and the average PHQ-9 score was 9.4 (range 0–23, with a maximum possible score of 27). The average score of the vulval-disease-specific questions was 7.8, with a maximum possible score of 12, which was observed in six patients. Overall, 59% of patients stated that they would like to have focused questions pertaining to the psychosexual burden of vulval skin disease included as part of patient questionnaires. We conclude that there is a marked psychological, psychosexual and quality-of-life impact associated with vulval skin disease. Standard dermatology patient rating scales such as the DLQI and PHQ-9 are helpful, but nonspecific. There is a role for a more focused questionnaire exploring the psychosexual burden of disease on our patients. We suggest that asking this cohort of patients these specific questions may enhance the communication between doctor and patient, ensure that their concerns are being addressed and also help measure success of treatments. Our results also highlight the potential role of psychological support within a vulval dermatology service.