Stigmatizing views and myths about psoriasis are pervasive in the United States

August 30, 2018

PHILADELPHIA - The stigma associated with the autoimmune disease psoriasis may lead people to avoid patients who show signs of the condition, including not wanting to date, shake hands, or have people in their homes if they suffer from the disease. New multidisciplinary research involving both psychologists and dermatologists from the Perelman School of Medicine at the University of Pennsylvania is the first to examine how common this stigma may be among the general population of the United States as well as among medical students. The study also found false perceptions about psoriasis continue to persist, including the belief that psoriasis is contagious and that it is not a serious illness. Researchers published their findings in the Journal of the American Academy of Dermatology today.

Psoriasis is a common, chronic autoimmune disease affecting more than eight million Americans, causing painful, thick, red patches on the skin that often itch and bleed. It also has profound effects on health-related quality of life, and in moderate to severe cases, it carries an increased risk of heart attack, stroke, and premature death. It is not contagious, and while it is treatable, there is currently no cure.

"Although it's widely recognized that the appearance of psoriasis can negatively impact patients' social, professional, and intimate relationships, we wanted to quantify the perceptions patients with psoriasis face on a daily basis in order to understand how pervasive they are," said the study's senior author Joel M. Gelfand, MD MSCE, a professor of Dermatology and Epidemiology at Penn. Rebecca L. Pearl, PhD, an assistant professor of Psychology in Psychiatry, was the lead author of the study.

Researchers used Amazon Mechanical Turk (MTurk), a web-based data collection service, to survey people about their perceptions of individuals with psoriasis. They also sent the survey directly to several hundred medical students. In all, 198 laypeople responded on MTurk and 187 medical students completed the emailed survey. All participants were shown images of people with psoriasis as well as close up photos of psoriasis lesions.

Overall, 54 percent of laypeople who responded said they did not want to date someone with psoriasis. Thirty-nine percent said they did not want to shake hands with someone suffering from the disease, while 32 percent said they did not want to have someone with psoriasis in their homes. Respondents also endorsed several stereotypes about people with psoriasis, with 57 percent saying they were insecure, 53 percent saying they were sick, 45 percent saying they were unattractive, and 27 percent saying they were contagious. Medical students demonstrated less stigmatizing views compared to the MTurk group. Among MTurk participants, those who knew someone with psoriasis or had heard of psoriasis demonstrated less stigmatizing attitudes.

"It's possible that better education about the disease, as well as contact with individuals with psoriasis, may help to dispel myths and stereotypes and reduce negative perceptions," Pearl said.

The researchers stressed the need for further research with a larger sample size before drawing any definitive conclusions. However, they said the findings do have implications for both public health and patient care.

"Future studies should evaluate the effects of education campaigns on people's attitudes toward those with psoriasis, as well as efforts to incorporate patients with psoriasis into general medical education for physicians and other health care providers," Gelfand said.
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Additional Penn co-authors on the study were Junko Takeshita, MD, PhD, MSCE, an assistant professor of Dermatology and Epidemiology, and Marilyn T. Wan, MBChB, MPH, a post-doctoral research fellow in Gelfand's lab.

This study was supported by a grant from the Edwin & Fannie Gray Hall Center for Human Appearance at the Perelman School of Medicine at the University of Pennsylvania. Pearl and Takeshita receive funding from the National Institutes of Health, and Wan receives funding from the National Psoriasis Foundation.

Penn Medicine is one of the world's leading academic medical centers, dedicated to the related missions of medical education, biomedical research, and excellence in patient care. Penn Medicine consists of the Raymond and Ruth Perelman School of Medicine at the University of Pennsylvania (founded in 1765 as the nation's first medical school) and the University of Pennsylvania Health System, which together form a $7.8 billion enterprise.

The Perelman School of Medicine has been ranked among the top medical schools in the United States for more than 20 years, according to U.S. News & World Report's survey of research-oriented medical schools. The School is consistently among the nation's top recipients of funding from the National Institutes of Health, with $405 million awarded in the 2017 fiscal year.

The University of Pennsylvania Health System's patient care facilities include: The Hospital of the University of Pennsylvania and Penn Presbyterian Medical Center -- which are recognized as one of the nation's top "Honor Roll" hospitals by U.S. News & World Report -- Chester County Hospital; Lancaster General Health; Penn Medicine Princeton Health; Penn Wissahickon Hospice; and Pennsylvania Hospital -- the nation's first hospital, founded in 1751. Additional affiliated inpatient care facilities and services throughout the Philadelphia region include Good Shepherd Penn Partners, a partnership between Good Shepherd Rehabilitation Network and Penn Medicine, and Princeton House Behavioral Health, a leading provider of highly skilled and compassionate behavioral healthcare.

Penn Medicine is committed to improving lives and health through a variety of community-based programs and activities. In fiscal year 2017, Penn Medicine provided more than $500 million to benefit our community.

University of Pennsylvania School of Medicine

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