Study reveals how psychological burden compounds the physical impact of living with skin disease

A major pan-European study has revealed that almost all patients affected by skin diseases face embarrassment, with the psychological burden compounding the physical impact of living with the disease.

The Burden of Skin Disease in Europe, published today in the Journal of the European Academy of Dermatology and Venereology (JEADV), analyzed 19,015 individuals with a range of skin diseases and revealed the huge psychological toll of living with a disease. The diseases examined included, amongst others, fungal skin infections, acne, atopic dermatitis (eczema), alopecia, psoriasis and sexually transmitted diseases (STDs).

With high levels of stigmatization, about 9 in 10 (88%) patients with skin disease considered their disease to be embarrassing in their personal life, with 83% reporting the same in their working life. Furthermore, almost 25% reported to have changed their professional activity due to their disease, and work life was particularly impaired in patients with acne (48%) and urticaria (60%).

Previous findings from The Burden of Skin Disease in Europe study show that almost half of the adult European population declared having at least one dermatological disease. The prevalence of skin diseases is likely to be significantly higher than this, and 40% of skin cancers and STD diagnoses remain unrecognized on the first consultation and diagnosed at later medical consultations.

This study highlights the alarming psychosocial challenge faced by individuals with skin diseases and underscores the need to provide psychological support to patients, and to mitigate the stigmatization that patients endure in their personal and professional lives. With a profound impact on mental health, these common diseases exert a significant toll on patients' quality of life."

Prof. Marie-Aleth Richard, lead author of the research

Surprisingly, despite their high prevalence, and in some cases severe psychological and physical impact, skin diseases receive limited policy, research and funding attention.

The journey of patients with skin diseases is frequently complex, with many patients avoiding medical consultations. This, in turn, contributes to the diseases being under-recognized and underfunded, with low awareness of the true burden that skin diseases cause on the European population. Many of the issues contributing to medical avoidance in skin diseases – which include a low perceived need for care and financial reasons – can be resolved with improved health literacy and consequential patient empowerment, ensuring that patients are better informed about their treatment possibilities.

Despite numerous challenges across the field, public perception of dermatologists across the continent is encouraging. Eight in 10 (81%) patients report that they are satisfied with their dermatology service and the medical information they receive.

"The burden is huge", adds Prof. Myrto Trakatelli, Chair of EADV's Advocacy Working Group. "In spite of this, skin diseases are systematically underestimated, and only a small number of interventions on tackling associated stigmatization have been published."

"Urgent action must now be taken to raise awareness of the impact that skin diseases have on individuals, economies and society and to ensure that patients receive the holistic care they need, including mental health support. Eliminating stigma across the field is of paramount importance to really improve the life of the many patients living with skin diseases, so we call on policymakers to take concerted action to address both the physical and psychological burden of skin diseases."

Source:
Journal references:
  1. Gisondi P, Puig L, Richard MA , Paul C, Nijsten T, Taieb C, et al. for the EADV Burden of Skin Diseases Project Team. Quality of life and stigmatization in people with skin diseases in Europe: A large survey from the 'burden of skin diseases' EADV project. J Eur Acad Dermatol Venereol. 2023; 37 (Suppl. 7): 6 – 14. https://doi.org/10.1111/jdv.18917
  2. Trialonis- Suthakharan N, Pattinson R, Tahmasebi Gandomkari N, Austin J, Janus C, Courtier N, et al. Patient prioritisation of impact items to develop the patient- reported impact of dermatological diseases (PRIDD) measure: European Delphi data. J Eur Acad Dermatol Venereol. 2023; 37 (Suppl. 7): 40 – 50. https://doi.org/10.1111/jdv.19266
  3. Editorial: The burden of skin disease in Europe. J Eur Acad Dermatol Venereol. 2023; 37 (Suppl. 7).
  4. Richard MA, Paul C, Nijsten T, Gisondi P, Salavastru C, Taieb C, et al. The journey of patients with skin diseases from the first consultation to the diagnosis in a representative sample of the European general population from the EADV burden of skin diseases study. J Eur Acad Dermatol Venereol. 2023; 37 (Suppl. 7): 17 – 24. https://doi.org/10.1111/jdv.18916
  5. McGrath BM, Hughes O. The dermatology patient journey from initial consultation to diagnosis. J Eur Acad Dermatol Venereol. 2023;37(Suppl. 7): 25 – 26. https://doi.org/10.1111/jdv.18987 '
  6. Augustin M, John SM. Learning lessons for the battle against disease burden and stigmatization in chronic skin diseases: Call for action needed? J Eur Acad Dermatol Venereol. 2023; 37(Suppl. 7): 15 – 16. https://doi.org/10.1111/jdv.18985
  7. Richard MA, Paul C, Nijsten T, Gisondi P, Salavastru C, Taieb C, et al. for the EADV burden of skin diseases project team. Public perception of dermatologists in Europe: Results from a population based survey. J Eur Acad Dermatol Venereol. 2023; 37 (Suppl. 7): 27 – 37. https://doi.org/10.1111/jdv.18988
  8. Tognetti L, Pasquali P, Moscarella E, Rubegni P. The perception of dermatologists across Europe: Comments from the tele-dermatology task force. J Eur Acad Dermatol Venereol. 2023; 37(Suppl. 7): 38 – 39. https://doi.org/10.1111/jdv.18986

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