Quality of life of patients with autoimmune bullous disease in Kabul, Afghanistan

Abstract Autoimmune bullous diseases (AIBDs) are chronic, potentially life-threatening disorders that significantly impair patients’ quality of life (QoL). Despite increasing global recognition of this burden, data from Afghanistan remain lacking. This study aimed to evaluate QoL and its association with disease severity among patients with AIBDs in Kabul Afghanistan. A descriptive cross-sectional study was conducted at Maiwand Teaching Hospital, Kabul, between December 2024 and March 2026. A total of 105 patients aged ≥ 16 years with dermatologist-confirmed AIBDs were included. QoL was assessed using the Persian versions of the Autoimmune Bullous Disease Quality of Life (ABQOL) and Treatment Autoimmune Bullous Disease Quality of Life (TABQOL) questionnaires (ABQOL/TABQOL score range 0–51, higher scores represent worse QoL). Disease severity was measured using the Autoimmune Bullous Skin Disorder Intensity Score (ABSIS) (score range 0-206, higher scores represent greater disease severity). Independent t-tests and Spearman correlation coefficients were used to compare quality of life scores. A p-value < 0.05 was considered statistically significant. The mean age of participants was 54.60 ± 11.98 years, with a slight female predominance (54.3%). Pemphigus vulgaris was the most common diagnosis (80.0%). The mean ABQOL and TABQOL scores were 23.85 ± 7.15 and 21.05 ± 6.26, respectively, indicating moderate QoL impairment. Patients with comorbidities had significantly higher ABQOL scores ( P = 0.007). ABQOL differed significantly by diagnosis, with worse scores among pemphigus vulgaris patients ( P < 0.001). No significant differences were observed by sex or educational status. ABQOL and TABQOL were moderately correlated ( r = 0.520, P < 0.001). Both scores showed significant positive correlations with ABSIS ( r = 0.705 and r = 0.528, respectively; P < 0.001), indicating that greater disease severity was associated with poorer QoL. Patients with AIBDs in Afghanistan experience moderate impairment in QoL, strongly associated with disease severity and comorbidities. These findings highlight the importance of disease control and comprehensive management strategies to improve patient outcomes in resource-limited settings.