Stigmatization and perceived health status in patients with hidradenitis suppurativa: an observational multicenter study in Europe

• Published in: International journal of dermatology 2024-11
• Main Authors: Marron, Servando E, Gracia-Cazaña, Tamara, Sampogna, Francesca, Schut, Christina, Kupfer, Joerg, Dalgard, Florence J, Bewley, Anthony, van Beugen, Sylvia, Gieler, Uwe, Lien, Lars, Ständer, Sonja, Vulink, Nienke, Finlay, Andrew Y, Legat, Franz J, Titeca, Geraldine, Jemec, Gregor B, Misery, Laurent, Szabo, Csanad, Grivcheva-Panovska, Vesna, Spillekom-van Koulil, Saskia, Balieva, Flora, Szepietowski, Jacek C, Reich, Adam, Roque Ferreira, Bárbara, Lvov, Andrey, Romanov, Dmitry, Svensson, Ake, Altunay, Ilknur K, Thompson, Andrew R, Zeidler, Claudia, Tomas-Aragones, Lucía
• Format: Article
• Language: English
• ISSN: 0011-9059; 1365-4632; 1365-4632
• DOI: 10.1111/ijd.17569

Hidradenitis suppurativa (HS) can severely affect the quality of life (QoL) and is linked to psychological distress, including anxiety, depression, and reduced self-esteem. Stigmatization due to physical appearance may significantly contribute to the psychological burden and impact on QoL for HS patients. This study investigates the association between stigmatization, depression, anxiety, and health- and disease-related variables among HS patients in Europe. This observational cross-sectional multicenter study was conducted across 22 dermatological outpatient clinics in 17 European countries. Data collected included sociodemographic variables, general health variables, disease-related variables, perceived stigmatization (PSQ), and mental health (PHQ-2, GAD-2). Of the 5487 dermatological patients, 142 (2.6%) were diagnosed with HS, and data from 135 patients (70.1% women, mean age 38.2 years) who completed the PSQ questionnaire were analyzed. Scores on the stigmatization measure indicated that significant stigmatization levels were present in the sample. Linear regression models revealed a significant relationship between stigmatization and both the duration of HS and the presence of itch. Similar findings were noted for the PSQ "confused/staring behavior" scale with depression. The PSQ "absence of friendly behavior" scale was inversely associated with general health status, whereas the "hostile behavior" scale was positively linked to depression. HS patients experience significant stigmatization linked to disease duration, itch, and depression. Comprehensive management, including screening for psychosocial co-morbidity, is essential, as is providing access to psychological interventions that support patients to both manage internal distress and the potential reactions of others.