New research unveils the hidden impact on mental health that some chronic skin conditions take for pediatric patients. 

The cross-sectional study, published in JAMA Dermatology, was conducted across 32 pediatric dermatology centers in the United States and Canada and aimed to explore the extent of stigma associated with chronic pediatric skin diseases, the dependence on disease visibility and severity, and their association with mental health outcomes.

Researchers included 1,671 pediatric patients aged 8 to 17 years with chronic skin conditions in the analysis, along with their parents. Using the Patient-Reported Outcomes Measurement Instrumentation System (PROMIS), they assessed stigma levels through various perspectives, including child-, caregiver-, and physician-assessed disease visibility.

The study results indicated that over half of the participants reported high disease visibility, with stigma scores significantly differing based on physician and child/proxy assessments of disease visibility and severity. A minority of children with chronic skin disorders experienced minimal or no stigma. Stigma scores were strongly correlated with reduced quality of life, depression, anxiety, and poor peer relationships. Nearly a third of parents were aware of their child experiencing bullying, which was strongly associated with stigma. Girls reported higher levels of stigma compared to boys. Additionally, children with specific conditions like hyperhidrosis and hidradenitis suppurativa were more likely to experience increased depression and anxiety.

"The findings of this study suggest that health care professionals should consider stigmatization and bullying in assessing the social and mental health of children and adolescents with chronic skin diseases," the authrs councluded. 

Source: Paller AS, Rangel SM, Chamlin SL, et al. Stigmatization and Mental Health Impact of Chronic Pediatric Skin Disorders. JAMA Dermatology. Published online 2024. Doi.org/10.1001/jamadermatol.2024.0594