Body-image and appearance concerns for people with psoriasis: a systematic review and synthesis of qualitative research.

Research highlights the impact of experiencing a chronic skin condition upon psychosocial functioning. One such condition is psoriasis, an autoimmune inflammatory condition, resulting in red, scaly plaques occurring on the skin. People with psoriasis may experience body-image concerns related to the visibility of psoriasis, which negatively impacts relationships, engagement in valued activity, and wellbeing. This review aimed to synthesise qualitative research regarding appearance concerns of people with psoriasis, with a focus on the impact of altered appearance on psychosocial functioning. A systematic search of four databases (Academic Search Ultimate, Cinahl, Medline and Psychinfo) identified 26 papers for inclusion. Analysis was conducted utilising thematic synthesis to generate an integrated account regarding the experiences of psoriasis patients. Three themes were developed from the data: Constructing and navigating the psoriasis-identity; Appearance stigmatisation; and Acceptance and coping with an altered appearance. Although individual differences in adjustment and coping long-term were identified, findings highlight the impact of psoriasis upon identity and psychosocial functioning. Psychologists working within dermatology may drive systemic change by developing psycho-dermatological care frameworks and offering consultation and training within multidisciplinary teams. Targeted therapies may support psoriasis patients to develop acceptance, and positive body-image, thereby increasing wellbeing.