2f:I[703058,["/_next/static/immutable/chunks/3bhq_5eh1d760.js","/_next/static/immutable/chunks/1855-ogyi8eh4.js","/_next/static/immutable/chunks/2pfsjpn6k6zlg.js","/_next/static/immutable/chunks/26c7v3_3uwnwu.js","/_next/static/immutable/chunks/25a3ozcrvi1ff.js","/_next/static/immutable/chunks/2r4wx50nvjh_4.js","/_next/static/immutable/chunks/23fsw06hsi5b1.js","/_next/static/immutable/chunks/06_yt270h41rg.js","/_next/static/immutable/chunks/3ezsiz-7shkna.js","/_next/static/immutable/chunks/20x2y96ldu5wx.js","/_next/static/immutable/chunks/2lxntcm3pd1_h.js","/_next/static/immutable/chunks/00dgco8irq3jw.js","/_next/static/immutable/chunks/00nwe-kq0rboc.js","/_next/static/immutable/chunks/2051ffx3xzio9.js"],"PaperListPageClient"] 30:T487,The study included 1671 children (57.9% female; mean [SD] age, 13.7 [2.7] years). A total of 56.4% participants had self-reported high disease visibility and 50.5% had moderate disease severity. Stigma scores significantly differed by level of physician-assessed and child/proxy-assessed disease visibility and severity. Among children with chronic skin disorders, predominantly acne, atopic dermatitis, alopecia areata, and vitiligo, only 27.0% had T scores less than 40 (minimal or no stigma) and 43.8% had at least moderate stigma (T score ≥45) compared with children with a range of chronic diseases. Stigma scores correlated strongly with reduced QOL (Spearman ρ = 0.73), depression (ρ = 0.61), anxiety (ρ = 0.54), and poor peer relationships (ρ = -0.49). Overall, 29.4% of parents were aware of bullying of their child, which was strongly associated with stigma (Cohen d = -0.79, with children who were not bullied experiencing lower levels of stigma). Girls reported more stigma than boys (Cohen d = 0.26). Children with hyperhidrosis and hidradenitis suppurativa were most likely to have increased depression and anxiety.31:T9bd,Chronic skin disorders in children frequently are visible and can cause stigmatization. However, the extent of stigmatization from chronic skin disease and association with mental health needs further study. To examine the extent of stigma, dependence on disease visibility and severity, and association with mental health and quality of life (QOL) in chronic pediatric skin disease. A cross-sectional, single-visit study was conducted at 32 pediatric dermatology centers in the US and Canada from November 14, 2018, to November 17, 2021. Participants included patients aged 8 to 17 years with chronic skin disease and 1 parent. Using the Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) Stigma-Skin, the extent of stigma with child-, caregiver-, and physician-assessed disease visibility (primary outcome) and severity was compared, as well as reduced QOL (assessed by Skindex-Teen), depression, anxiety, and poor peer relationships (PROMIS child and proxy tools) (secondary outcomes). The study included 1671 children (57.9% female; mean [SD] age, 13.7 [2.7] years). A total of 56.4% participants had self-reported high disease visibility and 50.5% had moderate disease severity. Stigma scores significantly differed by level of physician-assessed and child/proxy-assessed disease visibility and severity. Among children with chronic skin disorders, predominantly acne, atopic dermatitis, alopecia areata, and vitiligo, only 27.0% had T scores less than 40 (minimal or no stigma) and 43.8% had at least moderate stigma (T score ≥45) compared with children with a range of chronic diseases. Stigma scores correlated strongly with reduced QOL (Spearman ρ = 0.73), depression (ρ = 0.61), anxiety (ρ = 0.54), and poor peer relationships (ρ = -0.49). Overall, 29.4% of parents were aware of bullying of their child, which was strongly associated with stigma (Cohen d = -0.79, with children who were not bullied experiencing lower levels of stigma). Girls reported more stigma than boys (Cohen d = 0.26). Children with hyperhidrosis and hidradenitis suppurativa were most likely to have increased depression and anxiety. The findings of this study suggest that physician assessment of disease severity and visibility is insufficient to evaluate the disease impact in the patient/caregiver. Identifying stigmatization, including bullying, and tracking improvement through medical and psychosocial interventions may be a key role for practitioners.32:Tc52,ImportanceChronic skin disorders in children frequently are visible and can cause stigmatization. However, the extent of stigmatization from chronic skin disease and association with mental health needs further study.ObjectiveTo examine the extent of stigma, dependence on disease visibility and severity, and association with mental health and quality of life (QOL) in chronic pediatric skin disease.Design, Setting, and ParticipantsA cross-sectional, single-visit study was conducted at 32 pediatric dermatology centers in the US and Canada from November 14, 2018, to November 17, 2021. Participants included patients aged 8 to 17 years with chronic skin disease and 1 parent.Main Outcomes and MeasuresUsing the Patient-Reported Outcomes Measurement Instrumentation System (PROMIS) Stigma-Skin, the extent of stigma with child-, caregiver-, and physician-assessed disease visibility (primary outcome) and severity was compared, as well as reduced QOL (assessed by Skindex-Teen), depression, anxiety, and poor peer relationships (PROMIS child and proxy tools) (secondary outcomes).ResultsThe study included 1671 children (57.9% female; mean [SD] age, 13.7 [2.7] years). A total of 56.4% participants had self-reported high disease visibility and 50.5% had moderate disease severity. Stigma scores significantly differed by level of physician-assessed and child/proxy-assessed disease visibility and severity. Among children with chronic skin disorders, predominantly acne, atopic dermatitis, alopecia areata, and vitiligo, only 27.0% had T scores less than 40 (minimal or no stigma) and 43.8% had at least moderate stigma (T score ≥45) compared with children with a range of chronic diseases. Stigma scores correlated strongly with reduced QOL (Spearman ρ = 0.73), depression (ρ = 0.61), anxiety (ρ = 0.54), and poor peer relationships (ρ = −0.49). Overall, 29.4% of parents were aware of bullying of their child, which was strongly associated with stigma (Cohen d = −0.79, with children who were not bullied experiencing lower levels of stigma). Girls reported more stigma than boys (Cohen d = 0.26). Children with hyperhidrosis and hidradenitis suppurativa were most likely to have increased depression and anxiety.Conclusions and RelevanceThe findings of this study suggest that physician assessment of disease severity and visibility is insufficient to evaluate the disease impact in the patient/caregiver. Identifying stigmatization, including bullying, and tracking improvement through medical and psychosocial interventions may be a key role for practitioners.25:[[["$","script","0",{"type":"application/ld+json","dangerouslySetInnerHTML":{"__html":"{\"@context\":\"https://schema.org\",\"@type\":\"CollectionPage\",\"name\":\"Hyperhidrosis: condition Research & Clinical Takeaways\",\"description\":\"Explore peer-reviewed papers on Hyperhidrosis (condition). Clinician-written summaries and actionable practice insights. 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Accessed March 5, 2024. https://www.assessmentcenter.net/ac_scoringservice","article-title":null,"journal-title":null,"doi-asserted-by":null}],"short-title":[],"journal-issue":{"issue":"6","published-print":{"date-parts":[[2024,6,1]]}},"content-domain":{"domain":[],"crossmark-restriction":false},"original-title":[],"container-title":["JAMA Dermatology"],"published-print":{"date-parts":[[2024,6,1]]},"reference-count":29,"published-online":null,"references-count":29,"short-container-title":["JAMA Dermatol"],"is-referenced-by-count":26},"unpaywall":{"doi":"10.1001/jamadermatol.2024.0594","is_oa":true,"title":"Stigmatization and Mental Health Impact of Chronic Pediatric Skin Disorders","updated":"2025-07-30T00:59:52+00:00","published_date":"2024-04-24","best_oa_location":{"url":"https://www.ncbi.nlm.nih.gov/pmc/articles/11044010","pmh_id":"oai:pubmedcentral.nih.gov:11044010","url_for_pdf":null,"url_for_landing_page":"https://www.ncbi.nlm.nih.gov/pmc/articles/11044010"}}},"created_at":"2025-09-20T07:59:12.576Z","updated_at":"2025-09-20T08:40:34.801Z","tags":[{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"age_group","value":"pediatric","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"category","value":"Dermatology","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Acne","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Alopecia Areata","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Atopic Dermatitis","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Hidradenitis Suppurativa","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Hyperhidrosis","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Psoriasis","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"condition","value":"Vitiligo","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"level_of_evidence","value":"5","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"sample_size","value":"n=1671","value_numeric":1671},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"sex","value":"mixed","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"study_design","value":"Cross-Sectional Study","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"warning","value":"Comparator details for “children with a range of chronic diseases” are not described in the excerpt.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"warning","value":"Effect size signs in tables depend on group ordering; interpret direction using the table notes.","value_numeric":null},{"paper_doi":"10.1001/jamadermatol.2024.0594","tag_type":"warning","value":"Some diagnostic subgroups have very small sample sizes, so condition-specific estimates may be unstable.","value_numeric":null}],"summaries":{"what_studied":"Cross-sectional, single-visit study at 32 pediatric dermatology centers in the US and Canada (2018–2021) of 1671 children aged 8–17 with chronic skin disease and a parent. Stigma (PROMIS Stigma‑Skin) was examined by physician/child/proxy-rated visibility and severity, and its associations with quality of life (Skindex‑Teen), depression, anxiety, and peer relationships.","key_result":"Only 27.0% had minimal/no stigma (T<40) and 43.8% had at least moderate stigma (T≥45); stigma differed by visibility and severity and correlated with lower QOL (ρ=0.73), higher depression (ρ=0.61), higher anxiety (ρ=0.54), and poorer peer relations (ρ=−0.49). Bullying was reported by 29.4% of parents and was linked to higher stigma (Cohen d≈0.79), girls reported more stigma than boys (d=0.26), and stigma strongly predicted worse Skindex‑Teen total (estimate 1.05; 95% CI, 0.96–1.13).","limitations":"Cross-sectional, single-visit design limits causal inference. Conducted in specialty pediatric dermatology centers with small samples for some diagnoses (e.g., hyperhidrosis n=18; hidradenitis suppurativa n=22), which may affect generalizability and subgroup estimates.","practice_takeaway":"Do not rely solely on physician-rated severity or visibility to gauge impact. Routinely identify stigmatization and bullying and track change with validated tools to guide medical and psychosocial care."}}],"initialOffset":1,"fetchConfig":{"kind":"tags","tags":[{"tag_type":"condition","value":"Hyperhidrosis"}]},"breadcrumbItems":[{"name":"Home","href":"/"},{"name":"Research Hub","href":"/hub"},{"name":"Conditions","href":"/hub/tag/condition"},{"name":"Hyperhidrosis"}],"hrefConfig":{"basePath":"/hub/papers","webViewQueryParams":{"hub_ctx":"tag","hub_tag_type":"condition","hub_tag_value":"Hyperhidrosis"}}}]]

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