Quality of Life and Adjustment to Psychosocial Morbidity Among Adults Attending a Dermatology Clinic


  • AJ Ariba
  • AG Omisore




Dermatologicdisorders, Psychologicalmorbidity, Quality of Life, Skin, Stigma


Background: The skin is the largest organ in the body and has aesthetic significance. The presence of any skin lesion or skin disease might be associated with psychosocial morbidity and negative impact on the quality of life.

Objectives: To determine the level and degree of adjustment to psychosocial morbidity associated with the presence of dermatological conditions and assessing the quality of life of affected adults. 

Methods: Data were collected from 189 new patients attending the Dermatology Clinic at the Federal Medical Centre, Abeokuta, Nigeria using systematic random sampling. The validated Adjustment to Chronic Skin (ACS) diseases questionnaire and Finlay’s Dermatology Life Quality Index (DLQI) questionnaire were the research instruments.

Results: The respondents consisted of 80 males (42.3%) and 109 females (57.7%) with a mean age of 36.3± 15.3 years. The least adjustment to skin-related psychosocial morbidity (49.7%) was observed with the helplessness scale. The mean score on the DQoL was 9.9 ± 6.2 and over half of the respondents (53.9%) reported moderate to an extremely large negative effect on their quality of life.

Conclusion: The presence of dermatological conditions impact negatively on the quality of life and the least adjustment to skin-related psychosocial morbidity was experienced on the helplessness scale. Dermatology practitioners should acquire psychological evaluation and/or counselling skills to provide holistic care.


Morrison I, Loken LS, Olausson H. The skin as a social organ. Exp Brain Res 2010; 204: 305–314. https://doi.org/10.1007/s00221-009-2007-y

Roosta N, Black DS, Peng D, Riley W. Skin disease and stigma in emerging adulthood: impact on healthy development. J Cutan Med Surg. 2010; 14: 285-290. https://doi.org/10.2310/7750.2010.09053

Foggin E, Cuddy L, Young H. Psychosocial morbidity in skin disease. Brit J Hosp Med 2017; 78:C82-C86. https://doi.org/10.12968/hmed.2017.78.6.C82

Basra MKA and A.Y. Finlay AY. Family impact of skin diseases: The Greater Patient concept. Brit J Dermatol 2007; 156: 929–937. https://doi.org/10.1111/j.1365-2133.2007.07794.x

Basavaraj KH, Navva MA, Rashmi R. Relevance of psychiatry in dermatology: Present concepts. Indian J Psychiatry. 2010; 52: 270-275. https://doi.org/10.4103/0019-5545.70992

Ajose FO, Parker RA, Merall EL, Adewuya AO, Zachariah MP. Quantification and comparison of psychiatric distress in African patients with albinism and vitiligo: a 5-year prospective study. J Eur Acad Dermatol Venereol. 2014; 28: 925-932. https://doi.org/10.1111/jdv.12216

Roosta N, Black DS, Rea TH. A comparison of stigma among patients with leprosy in rural Tanzania and urban United States: a role for public health in dermatology. Int J Dermatol 2013; 52: 432-440. https://doi.org/10.1111/j.1365-4632.2011.05226.x

Sinha A, Kushwaha AS, Kotwal A, Sanghi S, Verma AK. Stigma in Leprosy: miles to go! Indian J Leprosy 2010; 82: 137-145.

Okoye IC, Onwuliri COE. Epidemiological and psychosocial aspects of onchocercal skin diseases in North-Eastern Nigeria. Filaria J 2007; 6: 15 https://doi.org/10.1186/1475-2883-6-15

Chouliara Z, Karen S, Buchanan P. The importance of psychosocial assessment in dermatology: Opening Pandora’s Box? Dermatol Nurs 2017 16: 30-34.

Chan F, Cardoso E, Chronister J, Hiatt E. Psychosocial Adjustment. In: Gellman MD, Turner JR (Eds) Encyclopedia of Behavioural Medicine. New York, NY. Springer. 2013. https://doi.org/10.1007/978-1-4419-1005-9_917.

Lifschitz C. The impact of atopic dermatitis on quality of life. Ann Nutr Metab 2015; 66: 34-40. https://doi.org/10.1159/000370226

Zhang X, Wang A, Shi T, Zhang T, Xu H, Wang D, et al. The psychosocial adaptation of patients with skin disease: a scoping review. BMC Public Health. 2019; 19: 1404. https://doi.org/10.1186/s12889-019-7775-0

Kassab YW, Muhamad SA, Aldahoul HK, Mohammed IK, Paneerselvam GS, Ayad MS. The impact of skin disorders on patients’ quality of life in Malaysia. J Clin Intensive Care Med 2019; 4: 001-009. https://doi.org/10.29328/journal.jcicm.1001018

Lavda AC, Webb TL, Thompson AR. A meta-analysis of the effectiveness of psychological interventions for adults with skin conditions. Brit J Dermatol 2012; 167: 970-979. https://doi.org/10.1111/j.1365-2133.2012.11183.x

Magin PJ, Adams J, Heading GS, Pond CD. Patients with skin disease and their relationships with their doctors: a qualitative study of patients with acne, psoriasis and eczema. Med J Aust 2009; 190: 62-64. https://doi.org/10.5694/j.1326-5377.2009.tb02276.x

Solanke M.O. Socio-economic characteristics of urban residents and intra-urban trip generation: an illustration from Abeokuta, Ogun State, Nigeria. Ethiopian J Env Studies Management 2015; 8: 593-605. http://dx.doi.org/10.4314/ejesm.v8i5.12

Stangier U, Ehlers A, Gieler U. Measuring adjustment to chronic skin disorders: validation of a self-report measure. Psychological Assessment. 2003; 15: 532-549. https://doi.org/10.1037/1040-3590.15.4.532

Echekwube PO, Omeh DJ, Olasode OA, Onayemi O. Quality of life of adult patients with vitiligo at a tertiary health care centre in Nigeria. Med. Med. Sci 2018; 6: 001-007. https://doi.org/10.15413/mms.2017.0105

Finlay AY, Khan GK. Dermatology Life Quality Index (DLQI)—a simple practical measure for routine clinical use. Clin Exp Dermatol 1994; 19: 210-216. https://doi.org/10.1111/j.1365-2230.1994.tb01167.x

Darlgard FJ, Gieler U, Tomas-Aragones L, Lien L, Poot F, Gemec GBE, et al. The psychological burden of skin disease in 13 European countries. J Investig Dermatol 2015; 135: 984-991. https://doi.org/10.1038/jid.2014.530

Goulding JMR, Harper N, Kennedy L, Martin K. Cost-effectiveness in Psychodermatology: A Case Series. Acta Derm Venereol 2017; 97: 663–664. https://doi.org/10.2340/00015555-2620

Arck PC, Slominski A, Theoharides T C, Peters EMJ, Paus R. Neuroimmunology of Stress: Skin Takes Center Stage. J Investig Dermatol 2006; 126: 1697–1704. https://doi.org/10.1038/sj.jid.5700104

Torales J, Di Martino B. Psychodermatology: mind the skin. Telangana J Psychiatry; 2016; 2: 5-7.

Barankin B, DeKoven J. Psychosocial effect of common skin diseases. Can Fam Physician 2002; 48: 712-716.

Almutlaq BA, Aljishi FK, Gaafar RA, Alyousif LA, Ahmed HG. Quality of life of Saudi patients with dermatological disorders. Clin Med Diagnostics 2018; 8: 1-6. https://doi.org/10.5923/j.cmd.20180801.01

Akinboro AO, Ezejiofor OI, Olanrewaju FO, Oripelaye MM, Olabode OP, Ayodele OE, et al. The impact of acne and facial post-inflammatory hyperpigmentation on quality of life and self-esteem of newly admitted Nigerian Undergraduates. Clin Cosmet Investig Dermatol 2018; 11: 245-252. https://doi.org/10.2147/CCID.S158129

Rumsey N. Psychosocial adjustment to skin conditions resulting in visible difference (disfigurement): What do we know? Why don’t we know more? How shall we move forward? Int J Women’s Dermatol 2018; 4: 2-7. https://doi.org/10.1016/j.ijwd.2017.09.005

Verhoeven EWM, de Klerk S, Kraaimaat FW, van de Kerkhof PCM, de Jong EMG, Evers AWM. Biopsychosocial Mechanisms of Chronic Itch in Patients with Skin Diseases: A Review. Acta Derm Venereol 2008; 88: 211-218.





Original Research