1
|
Gökşin Ş, İmren IG. Internalized stigma, disease severity, quality of life, anxiety and depression in axillary hyperhidrosis. Ann Dermatol Venereol 2024; 151:103291. [PMID: 39013257 DOI: 10.1016/j.annder.2024.103291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/31/2024] [Accepted: 05/14/2024] [Indexed: 07/18/2024]
Abstract
BACKGROUND Axillary hyperhidrosis (AH) is characterized by excessive underarm sweating. It is a chronic autonomic disorder that can lead to social embarrassment, impaired quality of life (QoL), anxiety and depression. Internalized stigma (IS), defined as the acceptance of negative societal attitudes and stereotypes about an individual's illness, has not been previously studied in AH. The aim of this study was to evaluate the level of IS in patients with AH and the relationships between IS, disease severity, quality of life, anxiety, and depression. PATIENTS AND METHODS One hundred and four patients with AH were included in the study. Demographic and clinical characteristics of the patients were recorded. The Hyperhidrosis Disease Severity Scale (HDSS) was used to define disease severity. Assessment was made using the Internalized Stigma Scale (ISS) (between 29 and 116, the higher the score the greater the stigma), Hospital Anxiety and Depression Scale (HADS) and Dermatology Life Quality Index (DLQI). RESULTS The mean age of the patients was 34.1 ± 10.9 years. The HDSS grade was mostly moderate to severe. The mean ISS score was 57.5 ± 6.5. Median HADS scores were 7 [interquartile range (IQR) 2-12] and 5 [IQR 2-10], respectively. HADS scores ≥ 8 were observed respectively in 39.4% and 8.7% of patients. The median DLQI score was 14 [IQR 4-24]. A DLQI score ≥ 11 was observed in 75% of patients. Significant correlation was found between ISS score and HDSS (r = 0.445, p < 0.001), HADS-A (r = 0.455, p < 0.001), DLQI (r = 0.478, p < 0.001) scores and symptom duration (r = 0.207, p = 0.035). The relationship between ISS and HADS depression scores was not statistically significant. CONCLUSION IS is common in patients with AH. Disease severity, symptom duration and anxiety increased IS. Patient's quality of life is reduced in AH.
Collapse
Affiliation(s)
- Ş Gökşin
- Pamukkale University Medical Faculty, Dermatology Department, Denizli, Turkey.
| | - I G İmren
- Denizli State Hospital, Dermatology Department, Denizli, Turkey
| |
Collapse
|
2
|
Abu Alqam R, Obaid H, Aljondi R, Alsulymani B, Aljohani R, Aleissa SM, Baabdullah A, Zimmo BS, Abduljabbar MH, Hariri J. The Extent of Misconceptions, Negative Prejudices, and Discriminatory Behaviors Toward Psoriasis Patients: A Cross-Sectional Survey Study Among the Population of Jeddah, Saudi Arabia. Cureus 2023; 15:e41678. [PMID: 37575830 PMCID: PMC10413171 DOI: 10.7759/cureus.41678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2023] [Indexed: 08/15/2023] Open
Abstract
Background Psoriasis is a chronic inflammatory disease that affects around 2% of the population. The lives of psoriasis patients are greatly impacted by stigma and social exclusion, regardless of the severity of the condition. This is the first study of its kind to be conducted in Saudi Arabia. This study aimed to assess peoples' psoriasis-related misconceptions, negative prejudice, and discriminatory behaviors. Methodology A self-administered Google Forms survey was distributed between January and February 2023. The survey was conducted among residents of Jeddah, Saudi Arabia who were enrolled randomly via social media. We aimed to investigate their perception and awareness related to psoriasis, as well as how varying educational levels, age groups, and genders affected these variables. Results In total, 803 individuals participated in the survey. Results showed that 19.9% of the participants did not know about psoriasis. Only 5.1% of respondents stated that they were well knowledgeable about psoriasis. Moreover, psoriasis was more frequently perceived as a communicable disease by people in the age group of 18-29 years (p = 0.000). Surprisingly, only 43.5% of the participants reported that they would shake hands with someone with psoriasis without hesitation. Additionally, 40.7% of the participants were aware that psoriasis requires lifelong treatment. Moreover, the belief that psoriasis does not require lifelong therapy was more prevalent among university graduates (p = 0.000). Conclusions This study found that the residents of Jeddah need further education on skin disorders, in general, and psoriasis, in particular. Future studies should be conducted utilizing various approaches, with a greater emphasis on certain groups of people who engage physically with psoriasis patients.
Collapse
Affiliation(s)
- Rakan Abu Alqam
- Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Haya Obaid
- Medicine, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Raghad Aljondi
- Medical School, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Badr Alsulymani
- Medical School, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Raghad Aljohani
- Medical School, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Saud M Aleissa
- Dermatology, King Abdulaziz University Hospital, Jeddah, SAU
- Dermatology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Ahmed Baabdullah
- Dermatology, King Abdulaziz University Hospital, Jeddah, SAU
- Dermatology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Bader S Zimmo
- Dermatology, King Abdulaziz University Hospital, Jeddah, SAU
- Dermatology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Mohammed H Abduljabbar
- Dermatology, King Abdulaziz University Hospital, Jeddah, SAU
- Dermatology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| | - Jehad Hariri
- Dermatology, King Abdulaziz University Hospital, Jeddah, SAU
- Dermatology, King Abdulaziz University Faculty of Medicine, Jeddah, SAU
| |
Collapse
|
3
|
Xie QW, Liang Z. Self-stigma Among Children Living with Atopic Dermatitis in Hong Kong: a Qualitative Study. Int J Behav Med 2022; 29:775-786. [PMID: 35132539 DOI: 10.1007/s12529-022-10059-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/26/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Stigma has been recently identified as a crucial factor associated with the psychosocial burden of those who have chronic skin diseases. The self-stigma experiences of children living with atopic dermatitis (AD) have yet to be fully investigated, and questions of how these children respond to public stigma and how AD symptoms further affect their self-stigma experiences remain unresolved. The current qualitative study aimed to (1) describe the main manifestations of self-stigma in children living with AD; (2) investigate factors that might influence their self-stigma experiences; and (3) explore the potential mechanisms underlying the impacts of AD on their psychosocial well-being from the self-stigma perspective. METHODS We performed a secondary analysis of the qualitative literal transcription data which were collected earlier by using the participatory, drawing-based qualitative interviews with 17 children aged 8-12 who were diagnosed with severe or moderate AD. RESULTS The qualitative findings indicated that the visible and invisible symptoms of AD and its management exerted unique influences on self-stigma in children living with AD, which manifested in cognitive, affective, and behavioral aspects and ultimately affected their psychosocial well-being. CONCLUSIONS Findings of this study allowed us to advocate for eliminating public stigma of people with skin diseases and propose recommendations for helping children living with AD relieve their self-stigma.
Collapse
Affiliation(s)
- Qian-Wen Xie
- Department of Social Welfare and Risk Management, School of Public Affairs, Zhejiang University, Hangzhou, China.,Center of Social Welfare and Governance, Zhejiang University, Hangzhou, China
| | - Zurong Liang
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, China.
| |
Collapse
|
4
|
Zhang H, Yang Z, Tang K, Sun Q, Jin H. Stigmatization in Patients With Psoriasis: A Mini Review. Front Immunol 2021; 12:715839. [PMID: 34867945 PMCID: PMC8634029 DOI: 10.3389/fimmu.2021.715839] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Accepted: 08/12/2021] [Indexed: 11/13/2022] Open
Abstract
Psoriasis is a chronic and recurrent immune-related skin disease that often causes disfigurement and disability. Due to the visibility of lesions in patients and inadequate understanding of dermatology knowledge in the general public, patients with psoriasis often suffer from stigma in their daily lives, which has adverse effects on their mental health, quality of life, and therapeutic responses. This review summarized the frequently used questionnaires and scales to evaluate stigmatization in patients with psoriasis, and recent advances on this topic. Feelings of Stigmatization Questionnaire, Questionnaire on Experience with Skin Complaints, and 6-item Stigmatization Scale have been commonly used. The relationship between sociodemographic characteristics, disease-related variables, psychiatric disorders, quality of life, and stigmatization in patients with psoriasis has been thoroughly investigated with these questionnaires. Managing the stigmatization in patients with psoriasis needs cooperation among policymakers, dermatologists, psychologists, psychiatrists, researchers, and patients. Further studies can concentrate more on these existing topics, as well as other topics, including predictors of perceived stigmatization, stigmatization from non-patient groups, influence of biologics on stigmatization, and methods of coping with stigmatization.
Collapse
Affiliation(s)
- Hanlin Zhang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Zihan Yang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Keyun Tang
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Qiuning Sun
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongzhong Jin
- Department of Dermatology, State Key Laboratory of Complex Severe and Rare Diseases, National Clinical Research Center for Skin and Immune Diseases, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
5
|
Skin Disease in Children: Effects on Quality of Life, Stigmatization, Bullying, and Suicide Risk in Pediatric Acne, Atopic Dermatitis, and Psoriasis Patients. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8111057. [PMID: 34828770 PMCID: PMC8619705 DOI: 10.3390/children8111057] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 11/09/2021] [Accepted: 11/10/2021] [Indexed: 12/23/2022]
Abstract
Acne, atopic dermatitis (AD), and psoriasis are all chronic dermatologic conditions that greatly impact the lives of pediatric patients and their caregivers. The visible nature of these diseases negatively affects the self-image of children early in life as well as their relationships with their families and peers. Physicians recognize the importance of addressing both the physical and mental symptoms of their patients but are currently not equipped with clear guidelines to manage long-term psychosocial comorbidities in pediatric dermatologic patients. A PubMed and Google Scholar search of key words was conducted to explore self-image in pediatric patients with acne, AD, and psoriasis. Chronic skin diseases put pediatric patients at risk for strained family relationships, poor self-image, psychiatric comorbidities, stigmatization, and eventual suicidal behavior. A limitation of this study is a lack of a validated measure of quality of life in the pediatric population that fulfills enough criteria to evaluate long term quality of life in children and adults. Possible management options, including connecting patients with the same diagnosis and allocating resources to parents and teachers to better understand these chronic skin conditions, may provide pediatric patients with the support they need to develop resilience in the face of these challenges.
Collapse
|