Longterm outcome of chronic disorders

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Several major skin disorders are chronic conditions where no cure is currently available.25,26 Whenever a definite cure is not reasonably attainable, it is common to distinguish between short, intermediate (usually measurable within months) and long-term outcomes. Long-term results are not simply predictable from short-term outcomes. Many skin disorders wax and wane over time and it is not easy to define what represents a clinically significant long-term change in the disease status. This is an even more difficult task than defining outcome for other clinical conditions such as cancer or ischaemic heart disease, where death or major hard clinical endpoints (for example myocardial infarction) are of particular interest. In the long term, the way the disease is controlled and the treatment side-effects are vital, and simply and cheaply measured outcomes applicable in all patients seem to be preferable.27 These may include the number of patients in remission, the number of hospital admissions or outpatient consultations and major disease flare-ups. Dropouts merit special attention because they may strongly reflect dissatisfaction with treatment.

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