Associations between site of skin lesions and depression, social anxiety, body-related emotions and feelings of stigmatization in psoriasis patients

Introduction: Research has demonstrated a link between psoriasis and a multitude of psychological impairments; however, relatively few studies have examined the importance of site of skin lesions for negative psychological outcomes in psoriasis patients.

Aim: To investigate relationships between anatomical location of psoriatic lesions and experiences of stigmatization, negative emotional attitude towards the body, depression and social anxiety.

Material and methods: Adult psoriasis patients (N = 193) completed the Stigmatization Scale, the Body Emotions Scale, the Beck Depression Inventory and the Social Anxiety Questionnaire. The body surface area index was used to assess the location and extent of psoriasis.

Results: Feelings of stigmatization were found to be most closely related to the presence of psoriatic lesions on the chest, and the arms and hands. Higher levels of social anxiety were found to be most closely related to the location of psoriatic lesions on the head and neck. Negative emotional attitude towards the body was found to be most closely related to the location of psoriatic lesions on the arms and hands, and on the head and neck. Higher levels of depressive symptoms were most closely related to the presence of psoriatic lesions on the head and neck, the arms and hands, and the genital area.

Conclusions: The presence of psoriatic lesions on the head, neck, and chest, and also on the arms and hands and the genital area, should alert clinicians to a higher risk of psychological impairments. This may help to better recognize and prevent cumulative life course impairment.