Comparison of the Psychological Impacts of Asymptomatic and Symptomatic Cutaneous Diseases: Vitiligo and Atopic Dermatitis

Abstract

BackgroundVitiligo and atopic dermatitis (AD) are common dermatological disorders which may cause significant psychological and social distress leading to impaired quality of life (QoL) in patients.ObjectiveWe evaluated the degree of psychological stress and impairment of QoL in vitiligo patients as compared with AD patients and normal controls (NCs).MethodsA total of 60 patients from each group and 60 NCs were enrolled. Five questionnaires on depression (Beck depression inventory, BDI), state anxiety (SA) and trait anxiety (TA), interaction anxiousness (IAS), private body consciousness (PBC) and dermatologic QoL were used.ResultsThe vitiligo patients had a significantly higher level of TA (p<0.01), PBC (p<0.001) and impaired QoL (p<0.001) than NCs, but not BDI, SA and IAS. The AD patients had significantly higher scores for all five questionnaire items compared with NCs. In the comparison between the AD and vitiligo groups, all of the indexes except body consciousness were higher in AD patients than in vitiligo patients: BDI (p<0.01), SA (p<0.05), TA (p<0.001), IAS (p<0.01) and impaired QoL (p<0.001). Exposure of vitiligo lesions was not a significant variable in the analysis of the contribution of clinical variables of vitiligo on psychological stress and QoL.ConclusionVitiligo, which is not accompanied by any symptoms, involves less psychological impact than AD, which is accompanied by itching. Compared to NCs, however, the elevated general anxiety and body consciousness in patients with vitiligo suggests that they may be more concerned with the aggravation of hypopigmented patches than difficulties in social interactions.

Impact of atopic dermatitis on quality of life in adults: a systematic review and meta‐analysis

“…Second, data on the relationship between specific AD characteristics and QoL suggest that itch, sleep disturbances, and exacerbations in facial and genital body areas could be relevant predictors of quality of life, as reported by a few studies in this review . A deeper insight into these relationships is important because of consequences for disease‐severity measurement in quality‐of‐life research; indeed, a more qualitative approach would help uncover some of these issues.…”

“…Two studies compared QoL between vitiligo and AD patients and found significantly lower QoL in the AD groups compared to the vitiligo groups (ps < 0.001). Four studies compared QoL between psoriasis and AD patients .…”

Comparing cutaneous research funded by the US National Institutes of Health (NIH) with the US skin disease burden

“…26 Dermatitis is well established with persistent loss of sleep cycle, intractable pruritus, stress, and impact on social interactions. [27][28][29][30][31] Thus, the GBD metric likely grossly underestimates the true burden from these skin conditions. Lobbying by specific disease interest groups such as the Melanoma Research Foundation and National Psoriasis Foundation may contribute to increased allocations for certain diseases.…”

Knowledge, beliefs, and perceptions of Turkish vitiligo patients regarding their condition

“…6-8 Because vitiligo is an asymptomatic disease, the team did not use the subscale of "symptoms" in the study. The second part of the questionnaire comprises four subscales: the cause subscale (17 items) measures personal ideas about the causes of vitiligo, the timeline subscale (3 items) deals with perceptions regardingdisease duration, the consequences subscale (6 items) treats the expected effects and outcomes of the illness, and the cure/control subscale (6 items) details beliefs about recovery from or control of the condition.…”