Abstract / Summary
Abstract Free clinics are a major healthcare access point for the underinsured patient population who face healthcare barriers that can exacerbate psychosocial burden. The Dermatology Life Quality Index (DLQI) survey is a commonly accepted and validated tool for measuring the impact of skin conditions on quality of life, however this impact remains largely unstudied in patients of dermatology free clinics. We conducted a cross-sectional survey of adults using the DLQI tool at two free dermatology clinics in San Antonio, Texas, between September 2024 and January 2026. The survey captured demographics, patient-reported clinical characteristics, and the 10-item DLQI. Responses with scorable DLQIs were analyzed. Fifty-three surveys were collected out of 547 patient encounters. Forty-two were analyzable. Participants averaged 39.0 years; 40.5% were female, 35.7% Hispanic, and 66.7% reported a high school education or less. Mean DLQI was 9.7 (SD 7.8; median 8.0). Sixty-four percent reported at least a moderate effect on quality of life and 33.3% a very large or extremely large effect. Embarrassment or self-consciousness was the most affected domain. Nearly one quarter did not know their diagnosis and 69.0% reported symptoms lasting one year or longer. Scores were higher among men, those with less education, and generalized disease. No comparison reached statistical significance. Dermatologic quality of life burden among free dermatology clinic patients appears high relative to reported general dermatology outpatient means, though contributing factors cannot be determined from this design. Limitations of this study include small sample size, self-reported diagnoses, and exclusion of Spanish responses. Further studies are needed to confirm these findings.