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Printed on 6/29/2026
For informational purposes only. This is not medical advice.
The Dermatology Life Quality Index (DLQI), developed by Finlay and Khan in 1994, is the most widely used dermatology-specific quality of life instrument. It consists of 10 questions covering symptoms, feelings, daily activities, clothing, social/leisure activities, sport, work/study, relationships, sex, and treatment. Each question scores 0–3, giving a total of 0–30. Scores ≤1 indicate no effect, 2–5 small effect, 6–10 moderate, 11–20 very large, and 21–30 extremely large effect. A DLQI >10 is a common threshold for eligibility for biologic therapies for psoriasis and other skin diseases. Pair with [PASI Score](/tools/pasi) for complete psoriasis severity documentation. Skin conditions commonly cause depression and anxiety — screen with [PHQ-9](/tools/phq9) and [GAD-7](/tools/gad7). For psoriasis patients, assess cardiovascular risk with [ASCVD Risk Calculator](/tools/ascvd-risk).
Formula: Sum of 10 questions (each 0–3). Total score range: 0–30.
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The questionnaire covers 10 domains: symptoms and feelings (Q1–2), daily activities (Q3–4), leisure (Q5–6), work/school (Q7), personal relationships (Q8–9), and treatment (Q10). It takes approximately 1–2 minutes to complete.
Each question scores 0 (not at all / not relevant) to 3 (very much). A score of 0 on any question may indicate 'not relevant' rather than no impact — this should be clarified when interpreting total scores near the floor.
Total score: 0–1 = no effect, 2–5 = small, 6–10 = moderate, 11–20 = very large, 21–30 = extremely large effect. A change of 4+ points is the minimum clinically important difference (MCID). Use alongside [PASI Score](/tools/pasi) for complete biologic eligibility documentation.
Dermatologists, practice administrators
NICE (England & Wales) requires DLQI >10 alongside PASI ≥10 for biologic approval in psoriasis. Most private insurers follow similar dual-criterion requirements. Document DLQI at baseline before starting any systemic therapy.
Patients with chronic skin conditions
The DLQI is patient-completed and validated in over 120 languages across 40+ skin conditions. Completing it before clinic visits helps patients articulate quality-of-life impact beyond what a physician can observe on examination alone.
Dermatologists, dermatology nurses
Serial DLQI scores at baseline and at weeks 12, 24, and 52 track whether treatment is achieving patient-centered improvement. A DLQI reduction ≥4 points (the MCID) is required to demonstrate a meaningful treatment response.
Clinical trial investigators, health economists
DLQI is a validated, widely-used patient-reported outcome (PRO) measure in dermatology trials and health technology assessments. Mean DLQI change is a secondary or co-primary endpoint in most pivotal biologic trials.
Primary care physicians, GPs
Skin conditions commonly cause depression and anxiety. A high DLQI despite mild-appearing disease should prompt screening with [PHQ-9](/tools/phq9) and [GAD-7](/tools/gad7), as psychological burden often exceeds what clinical severity scores capture.
Rheumatologists, dermatology nurses, specialty pharmacists
For patients with psoriatic arthritis receiving biologic therapy, DLQI provides skin-specific quality-of-life data to complement joint assessments. It is also required by specialty pharmacy benefit managers for continued medication authorization.
Patients complete the DLQI most accurately when done in the waiting room before seeing the physician. Post-consultation completion can be influenced by what was discussed. Paper or digital completion before the visit also ensures the clinician reviews it during the appointment.
The NICE threshold for biologic eligibility in psoriasis is DLQI >10 (not ≥10). A score of exactly 10 does not meet the criterion. Accurate completion, patient clarification of ambiguous questions, and documentation of the raw scores (not just the total) are important for insurance purposes.
Only reductions ≥4 DLQI points represent a clinically meaningful improvement as perceived by the patient. Small changes (1–3 points) are within the measurement error of the instrument. Use this threshold when making treatment continuation decisions.
The DLQI is validated for adults aged 16 and over. For children and adolescents, use the Children's DLQI (CDLQI), which is available in validated translations for most languages and uses age-appropriate language and scenarios.
If a patient answers 'not relevant' (N/A) on question 7 (work or study effects), this question should be scored 0 (not 3). This means the maximum possible DLQI for unemployed/retired patients is 27, not 30 — an important distinction for threshold assessments.
PASI captures clinical severity; DLQI captures patient experience. A patient with PASI 8 but DLQI 18 (e.g., hands or face affected) may have a greater burden than one with PASI 14 and DLQI 5. Both dimensions matter for treatment decisions.
Insurance companies typically require annual re-authorization for biologics and often ask for DLQI documentation at each renewal. Maintain a record of serial DLQI scores (baseline, 16 weeks, annual) to demonstrate ongoing treatment necessity.
DLQI was developed by Finlay and Khan (1994) and has since been validated in over 40 skin conditions and 120 languages. NICE Technology Appraisal TA 103 (2006) established the DLQI >10 threshold for biologic eligibility in psoriasis. The MCID of 4 points was defined by Basra et al. (2015).
Your DLQI score reflects the impact of your skin condition on your quality of life over the past week. A score of 0-1 means your skin disease has no effect on your life. A score of 2-5 indicates a small effect. A score of 6-10 indicates a moderate effect on daily activities. A score of 11-20 indicates a very large effect, meaning your skin condition is significantly interfering with your daily life, work, relationships, or emotional well-being. A score of 21-30 indicates an extremely large effect.
A change of 4 or more points in the DLQI is considered the minimal clinically important difference (MCID), meaning that a change of this magnitude reflects a meaningful improvement or worsening that the patient can perceive. Tracking your DLQI over time helps assess whether your treatment is working and whether adjustments are needed.
Use the DLQI at initial assessment for any skin condition that may affect quality of life, and at follow-up visits to monitor treatment response. It is particularly important in psoriasis, atopic dermatitis, hidradenitis suppurativa, and chronic urticaria, where a DLQI score greater than 10 is used by NICE and other guidelines as a threshold criterion for eligibility for biologic therapies.
The DLQI is also valuable in clinical trials as a patient-reported outcome measure and in clinical practice for documenting the patient perspective of disease burden. It takes only 1-2 minutes to complete and can be administered in the waiting room before the consultation.
The DLQI is designed for adults aged 16 and older. For children and adolescents, the Children's DLQI (CDLQI) should be used instead. The questionnaire captures impact over the past week only, which means it may miss intermittent or cyclical conditions that flare and remit over longer periods.
The DLQI has been criticized for potential floor and ceiling effects, and some studies suggest it may not fully capture the psychological burden of visible skin disease, particularly in conditions affecting the face or hands. Cultural differences in the perception and reporting of quality of life may also affect scores. Additionally, the DLQI does not assess disease severity directly — a patient with mild clinical disease but high psychological impact may score higher than one with severe disease who has adapted well.
For related assessments, see PASI Score, Burns BSA and ABCDE Melanoma Check.
Disclaimer: This tool is for educational and informational purposes only. It is not a substitute for professional medical advice, diagnosis, or treatment. Always consult a qualified healthcare provider with questions about your health.
April 21, 2026 · trust-baseline
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