Lesions on the back of hands and female gender predispose to stigmatization in patients with psoriasis

Publication date: Available online 6 January 2017
Source:Journal of the American Academy of Dermatology
Author(s): Marlena Hawro, Marcus Maurer, Karsten Weller, Romuald Maleszka, Anna Zalewska-Janowska, Andrzej Kaszuba, Zofia Gerlicz-Kowalczuk, Tomasz Hawro
BackgroundPsoriasis vulgaris is characterized by disfiguring and stigmatizing skin lesions. The links among lesions distribution, severity, and stigmatization remain unclear.ObjectiveWe sought to investigate if the involvement of visible and sensitive areas is linked to stigmatization.MethodsIn all, 115 patients with psoriasis vulgaris were assessed for disease severity, skin lesions distribution, itch, and stigmatization using the Feelings of Stigmatization Questionnaire. Quality of life was assessed with the Dermatology Life Quality Index and the World Health Organization Quality of Life-BREF.ResultsThe localization of psoriatic lesions on the back of hands was related to higher stigmatization levels (P = .011, total score of the Feelings of Stigmatization Questionnaire), but not the involvement of nails, the palms, the face, or the genital area nor overall disease severity. All patients reported some level of stigmatization, regardless of the localization of lesions and type of psoriasis. Higher levels of stigmatization characterized patients who claimed not to be able to hide their lesions by clothing (P = .025), women (P = .001), and the unemployed (P = .004). Stigmatization was the strongest predictor of quality of life impairment.LimitationsOnly hospitalized patients were included.ConclusionsPsoriatic lesions on the back of hands are debilitating and warrant effective treatment. Special attention should be paid to female patients, who are more sensitive to stigmatization.



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