الفهرس 
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Abstract
Historically, the impact that skin diseases have on quality of life was deemed insignificant. More recently, there has been widespread acknowledgment that skin diseases can affect psychological and social welfare and patients’ everyday lives, as well as their partners, families and friends .
Although acne , vitiligo , psoriasis and atopic dermatitis are not life threatening diseases , many studies have revealed that they have significant effect on self-image causing psychological impairement and bad quality of life.
Acne is a chronic inflammatory disease of pilosebaceous units during adolescence, a period with psychological instability .. It is characterised by blackheads and whiteheads, known as comedones, as well as pus-filled spots known as pustules . It usually develops in puberty and can vary in severity. For the majority of people, acne resolves by the late teens or early twenties, but for some it continues even longer. Some people might develop acne for the first time in their twenties or thirties .
Acne frequently affects the face, is difficult to hide, and the scars can persist for years or for life which reveal asignicant effect on self confidence and cause psychological impairement.
Atopic eczema also known as atopic dermatitis, this is an inflammatory condition of the skin in which the skin become dry, broken, sore, itchy and red . The affected sites are often skin creases such as the folds of the elbows or the backs of the knees .The pruritus or itching of atopic dermatitis can aggravate depression in depression- prone individuals, who then often scratch more and worsen their skin disorder .
Various psychological disturbances can occur, such as sleeplessness, resulting in problematic psychosocial functioning of the child and they may experience performance issues at school because of sleep deprivation . children with moderate or severe eczema have been found to have twice as many psychological issues as those without the condition.
Psoriasis is a chronic, relapsing and remitting, inflammatory skin condition that produces well-demarcated, silvery, erythematous, indurated, dry, scaly plaques . It can occur anywhere on the body, but common sites include the elbows, knees, lower back and scalp .
Psoriasis occurs as part of a complex set of interactions taking place between different genetic, immunological, systemic and environmental . Psoriasis can be a lifelong condition and so it is essential that quality of life issues are addressed, especially given the lengthy time patients may experience the symptoms .
Vitiligo is a chronic pigmentary disorder of the skin. The disease is characterized by circumscribed depigmented macules or patches corresponding with a substantial loss of functioning epidermal and sometimes hair follicle melanocytes. The natural course of vitiligo can include flares, remissions and spontaneous repigmentation .
People may be embarrassed or depressed by the appearance of their skin as well as by people questioning them about their condition .
This study was designed to determine the impact of some chronic skin diseases (acne vulgaris , psoriasis , AD and vitiligo ) on quality of life and psychiatric status in Egyptian teenage patients.
The study included 160 teenaged patients ( 13 – 18 years old ) subdivided into 4 groups ( 40 patients each ) , having psoriasis, vitiligo, AD and acne vulgaris diagnosed according to the classic clinical criteria for these dermatoses , we copmared their Qol and psychological impairement to each other and to 160 age- and sex- matched healthy volunteers. We evaluated the clinical severity of their diseases and psychcological status using dermatological severity scale
for each disease , PCASEE for quality of life scale, Coopersmith inventory for Self esteem , Beck depression inventory for depression and Hamilton scale for anexity ).
We reported from our study that dermatological problems are more than a cosmetic problem and can be associated with psychosocial effects that seriously affect obviously patients’ lives as the study showed that acne vulgaris , psoriasis , vitiligo and AD had poor impact on Qol , causing various degrees of depression and anxiety and lower the self esteem of the patients .
The study showed that Acne had the lowest Self esteem while psoriasis had the worst impact on Qol and caused severe anxiety and depression compared to the other diseases .
The study also showed that the more severe the skin disease is , the worse the impact on Qol and the more psychiatric morbidity and that sex difference might influences self perception and psychological status of chronic skin diseases diseases .