Anticipated and Perceived Stigma Among Patients With Psoriasis

J Psoriasis Psoriatic Arthritis. 2020 Jul;5(3):93-99. doi: 10.1177/2475530320924009. Epub 2020 Jun 8.

Abstract

Background: Perceived stigma among patients with psoriasis (PWP) is associated with poorer quality of life.

Objective: To determine the prevalence and predictors of stigmatizing attitudes that PWP expect and experience from others.

Methods: We conducted a survey using validated outcome measures to assess the extent to which PWP anticipate and perceive stigma from others. Demographic and clinical characteristics were obtained from electronic medical records.

Results: Patients (n = 106) were 48.11% female, 70.75% white, and had a mean age ± SD of 47.90 ± 16.19 years old. Of all, 25.47% self-reported their psoriasis as severe. Mean physician global assessment score ± SD was 2.98 ± 1.81. Two-thirds (66.98%) of patients reported that, in response to seeing their psoriasis-affected skin, they anticipated others to stereotype them as "contagious." Linear regression analyses demonstrated that patient-reported severe psoriasis, compared to mild psoriasis, was associated with greater anticipation of negative stereotypes, social avoidance, and perceived stigma from others (P values < .05). Physician-measured body surface area and global assessment scores were not significantly associated with any outcome.

Conclusion: Prevalence of anticipated and perceived stigma among PWP is high. Our results suggest that objective measures of severity may not identify patients at risk of stigma-related distress. Additional methods, such as directly inquiring about stigmatizing experiences, may be needed.

Keywords: attitudes; medical education; psoriasis; quality of life; stigma.