Psoriatic lesions on back of hand tied to higher stigmatization levels
Stigmatization is likely among patients with psoriatic lesions on the back of their hands. They require effective treatment, particularly female patients as they are more sensitive to stigmatization, suggests a recent study.
To determine whether the involvement of visible and sensitive areas is associated with stigmatization, researchers assessed 115 patients with psoriasis vulgaris for disease severity, skin lesions distribution, itch and stigmatization using the Feelings of Stigmatization Questionnaire. Dermatology Life Quality and the World Health Organization Quality of Life-BREF were used to evaluate quality of life.
There were greater stigmatization levels (p=0.011, total score of the Feelings of Stigmatization Questionnaire) associated with the localization of psoriatic lesions on the back of hands, but not the involvement of nails, the palms, the face, or the genital area nor overall disease severity.
Regardless of the localization of lesions and type of psoriasis, some level of stigmatization was reported by all patients. Women (p=0.001), the unemployed (p=0.004) and those who claimed not to be able to hide their lesions by clothing (p=0.025) had higher levels of stigmatization.
Moreover, the strongest predictor of quality of life impairment was stigmatization, according to researchers, adding that the study was limited by the inclusion of only hospitalized patients.
Stigmatization refers to experiencing a discrediting mark that leads to social discrimination and alienation. According to the Feelings of Stigmatization Questionnaire, the major aspects of stigmatization are anticipation of rejection and feelings of guilt and shame, the levels of which are significantly associated with pruritus intensity, stress prior to exacerbation, depressive symptoms and quality of life. [Acta Derm Venereol 2012;92:67-72]