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Table 5 Details of reviewed studies about birthmarks, according to location, sample, method design and significant outcomes

From: Psychosocial implications of rare genetic skin diseases affecting appearance on daily life experiences, emotional state, self-perception and quality of life in adults: a systematic review

Setting

Method

Results

Study quality

Ref

Location

N

Design

Tools

Comparator(s)

IV(s)

DV(s)

Significant outcomes

Wang et al. [102]

China

197

Cross-sectional—quantitative (moderate)

Questionnaire (DLQI)

196 vitiligo subjects

PWS characteristics

Skin-disease-specific QoL

PWS patients QoL↓ vs. vitiligo patients (esp. feelings, daily activities, leisure, work/school, treatment)***

QoL↓ ← ♀; hypertrophy↑; size of skin lesion↑*

High

Hagen et al. [101]

USA

244

Cross-sectional—quantitative (low)

Questionnaire (Skindex-29; OGs)

14 other skin conditions extracted from previous studies

Socialization w/ others; medical comorbidities; PWS severity; treatments

Skin-disease-specific QoL

Anxiety & depression: most reported comorbidities and associated w/ impact on QoL↑***

QoL ↔ comorbid depression**, limited facial mobility**, presence of other skin conditions*

Emotional impairments↓ ↔ older patients**, patients from educationnal services***

PWS hypertrophy ↔ emotional↑* & symptomatic↑*** impairments

Functional impairments↓ ↔ close friends↑* & social engagements↑*

PWS patients: QoL↓ vs. non-affected subjects (but similar to CTCL, rosacea, alopecia & vitiligo)

Moderate

Augustin et al. [132]

Germany

70

Cross-sectional—quantitative (low)

Dermatologist's clinical assessment; Questionnaires (SCL-53R; ALLTAG; CSDQ; FKS; OGs)

1006 non-affected subjects (extracted from another study)

Skin-specific coping; impact of PWS; global QoL limitations

Emotional well-being; body image

PWS patients: emotional well-being↓ (interpersonal sensitivity***, anxiety**, hostility**, phobic anxiety**, paranoid ideation**); body perception↓ (attractiveness/self-confidence*); QoL↓ (social relationship*) vs. non-affected subjects

Body perception & emotional well-being ↔ physical malaise*

High

Ben-Tovim & Walker, [131]

Australia

52 (including about 5 adolescents)

Cross-sectional—quantitative (moderate)

Questionnaires (BAQ)

49 rheumatoid arthritis; 23 eczema/psoriasis; 50 type 1 diabetes; 174 non-affected subjects

Body informations (height, weight, BMI)

Body-related attitudes

BVD patients: body-related attitudes impacted (strength/fitness↑*; salience of weight/shape↓*)

Moderate

Lanigan & Cotterill, [130]

England

71 (including about 5 adolescents)

Cross-sectional—quantitative (low)

Questionnaires (GHQ; HADS; OGs)

N/A

PWS characteristics

General health; Emotional state; Attitudes toward their PWS

No significant impact of PWS on emotional or psychiatric state

Social difficulties in PWS patients: dealing with strangers' reactions; need to hide the mark or treat it; impact on self-confidence; feeling different from others; feeling unattractive

Moderate

Malm & Carlberg, [133]

Sweden

23

Exploratory -qualitative (low)

Structured interviews

N/A

N/A

N/A

Patients with Large PWS: dealing with strangers' reactions (emotionally difficult); family as a source of support; childhood's bad experiences; very different coping in social contexts (withdrawall, taunt, humor); mark-hiding techniques (make-up)

Patients with Small PWS: mark-hiding techniques (make-up); dealing with strangers' (paranoid anxiety about PWS); exaggerated self-consciousness about the PWS

Low

  1. All study considered socio-demographic aspects (for example: age; gender; education lvl; socio-economic status; profession; etc.)
  2. IV Independent variable; DV Dependent variable; GTM Grounded theory methodology; TCA Thematic content analysis; PWS Port-wine-stains; CTCL Cutaneous T-cell lymphoma; BVD Blood vessel disorders; MLR Multiple linear regression; pop Population
  3. A ↔ B: A is associated with B; A → B: A predicts B; A↑: A is higher/more important; A↓: A is lower/less important; with: w/; without: w/o; vs.: compared to…
  4. p < 0.05*; p < 0.01**; p < 0.001***