Stigma and Myths about Psoriasis Are Pervasive in the U.S.

By Jane Farrell

The autoimmune disorder psoriasis is surprisingly stigmatized today among people in the U.S., according to researchers from the Perelman School of Medicine at the University of Pennsylvania.

The study, which involved both psychologists and dermatologists, was published in the Journal of the American Academy of Dermatology.

Investigators found that the stigma associated with the condition may lead people to avoid psoriasis patients, including not wanting to date them, shake hands or have the patients in their homes.

The study 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. Investigators also found that false perceptions about psoriasis itself continue to persist, including the belief that psoriasis is contagious and that it is not a serious illness.

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 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.