Vitiligo as a psychosocial disease: apprehensions of patients imprinted by the white

Abstract

This study aimed to show the comprehension that patients bearing vitiligo have over their condition, also assessing the association with their health and disease concepts. It is a qualitative research with descriptive and exploratory purposes, carried out from an epidemiological survey throughout the years of 2010-2013, with records from a dermatology outpatient care sector of a seminal hospital located in the city of Campina Grande – Paraíba, Brazil. It was identified that from the 832 existing records, 13 were of vitiligo patients and, from them, eight agreed to be part of this study, answering a semi-structured questionnaire. Data examination was made using the Thematic Content Analysis technique, identifying four categories. Results indicated that the process of being stricken with the disease is directly related to social practices that target the “stained” subject, over whom vitiligo has imprinted its patches.

Representational Structure of Vitiligo: Non-Restrictive Skin Marks

“…We also highlight that the anxiety evidenced in the evocations of the social actors as participants in the present study, has also been identifi ed in participant's speeches in research conducted by Do Bú et al (2018), who emphasized the belief that emotional factors are related to the onset and progression of Vitiligo. However, on this point, the literature does not present consensus, and it is principally argued that the disease aff ects the individual's quality of life, resulting in low self-esteem, psychiatric comorbidities, sadness, fear, insecurity and anger (Ajose, Parker, Merrall, Adewuya, & Zachariah, 2014;Bonotis et al, 2015;Correia & Borloti, 2013;Pahwa et al, 2013;Sarham, Mohammed, Gomaa, & Eyada, 2016).…”

“…Thus, considering that construction of both the self-concept and self-image of a person are associated with evaluations realized and originating in social relations and socially instituted body standards, Vitiligo brings negative values (Do Bú et al, 2018). It is evident from the results of this research that the eff ects of the disease are not restricted to the skin of those who have it, but, eminently overlap as psychosocial marks.…”

“…27, nº 3, p. 615-629 -September/2019 scenario in the last decades on the subject, these, to a large extent, point out only to the need for more systematic and verifi able studies that explain which biological factors are predictive of the onset and the condition progression (Akrem, Baroudi, Aichi, Houch, & Hamdaoui, 2008;AlGhamdi, 2010;Antelo, Filgueira, & Cunha, 2008;Dellatorre, Bertolini, & Castro, 2017;Khurrum, & AlGhamdi, 2017;Lerner, 1959;Njoo & Westerhof, 1997;Panda, 2005;Prasad & Bhatnagar, 2003;Rosa & Natali, 2009). For focusing on the Vitiligo's pathophysiological characteristics, such studies eventually disregard the psychosocial implications of changes in lifestyle that the disease causes, given the individual's self-perception and self-conception changes, the increase in experiences with tension and anxiety states (since the prognosis for Vitiligo is unknown), modifi cations in the individual's social dynamics and the need to deal with prejudice expressed in curious glances at the white patches, adverse comments, and retreats from regular touching (Do Bú, Alexandre, Scardua, & Araújo, 2018;Müller & Ramos, 2004;Sant'Anna, Giovanetti, Castanho, Bazhuni, & La Selva, 2003;Silva, Castoldi, & Kijner, 2011).…”

“…Do Bú et al (2018), indicates that eight participants under study attested to prejudice, (due to Vitiligo's conspicuousness), either directly (pejorative comments and/or retreat from touching), or camoufl aged (as in curious looks). From this perspective, one may discuss fl agrant and subtle prejudice, in which the former is expressed through hostility directed towards the member of the other group, considering the member as belonging to a weaker or lower group; while the latter manifests itself as a justifi ed discourse and seemingly positive behaviors are activated, yet permeated by the same ideology underlying fl agrant prejudice (Pettigrew & Meertens, 1995).…”

<p>Relationship Between Depression and Quality of Life Among Vitiligo Patients: A Self-assessment Questionnaire-based Study</p>

“…2 In addition to the physical effects of vitiligo, this condition exerts adverse psychological effects and causes social stigmatization. 3 Moreover, the effects of vitiligo may be more pronounced among people with darker skin due to the greater contrast between their normal skin color and their white-colored depigmented lesions. The understanding and acceptance of vitiligo may vary among cultures, with greater adverse effect on marriage and family relationships in less accepting cultures.…”