DLQI Responses

Name:                 %first_name% %last_name%
Date of Birth:        %date_of_birth%
Diagnosis:            %diagnosis%

Question Value 1. Over the last week, how itchy, sore, painful or stinging has your skin been? %dlqi_1% 2. Over the last week, how embarrassed or self-conscious have you been because of your skin? %dlqi_2% 3. Over the last week, how much has your skin interfered with you going shopping or looking after your home or garden? %dlqi_3% 4. Over the last week, how much has your skin influenced the clothes you wear? %dlqi_4% 5. Over the last week, how much has your skin affected any social or leisure activities? %dlqi_5% 6. Over the last week, how much has your skin made it difficult for you to do any sport? %dlqi_6% 7. Over the last week, has your skin prevented you from working or studying? %dlqi_7_1% 8. Over the last week, how much has your skin created problems with your partner or any of your close friends or relatives? %dlqi_8% 9. Over the last week, how much has your skin caused any sexual difficulties? %dlqi_9% 10. Over the last week, how much of a problem has the treatment for your skin been, for example by making your home messy, or by taking up time? %dlqi_10%