Internalized Stigma in Hidradenitis Suppurativa: A Multicenter Cross-Sectional Study

Bilgic A., Fettahlloglu Karaman B., Demirseren D. D., Clnar L., Kacar N., Türel Ermertcan A., ...More

Dermatology, vol.239, no.3, pp.445-453, 2023 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 239 Issue: 3
  • Publication Date: 2023
  • Doi Number: 10.1159/000529194
  • Journal Name: Dermatology
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts, CINAHL, EMBASE, Food Science & Technology Abstracts, MEDLINE
  • Page Numbers: pp.445-453
  • Keywords: Hidradenitis suppurativa, Internalized stigma, Psychodermatology, Quality of life
  • Erciyes University Affiliated: Yes


Background: Hidradenitis suppurativa (HS) causes significant physical, social, and psychological burdens. Internalized stigma, acceptance of negative attitudes and stereotypes of society regarding a person's illness, has not been studied previously in HS. Objectives: The objective of this study was to investigate the internalized stigma state of HS patients and identify the factors affecting it. Methods: This multicenter, prospective, cross-sectional study included 731 patients. Internalized Stigma Scale (ISS), Hurley staging, Physician Global Assessment, Dermatology Life Quality Index (DLQI), Skindex-16, Beck Depression Inventory-II (BDI-II), and Visual Analog Scale (VAS)-pain score were used in the study. Results: The mean ISS value (57.50 ± 16.90) was comparable to the mean ISS values of studies in visible dermatological and various psychiatric diseases. A significant correlation was found between the mean values of ISS and all disease activity scores, quality of life measures, BDI-II, and VAS-pain scores. Obesity, family history, low education and income level, vulva/scrotum involvement and being actively treated are significant and independent predictive factors for high internalized stigma in multivariate analysis. Conclusions: HS patients internalize society's negative judgements, which may create a profound negative effect on access to health care. Therefore, in addition to suppressing disease activity, addressing internalized stigma is fundamental for improving health care quality.