Psychosocial Impact of Keloid Disorder: A Comparative Study of Body App reciation, Anxiety, and Depression against Hypertrophic and Post-Burn Scars
Sofia de Carvalho Leal, MS, Débora Barbosa Rocha Ribas, MS,
BACKGROUND
Beyond physical sequelae, patients with Keloid Disorder often experience anxiety, depression, reduced self-esteem, stigmatization, and social withdrawal, all of which contribute to a negative impact on quality of life. Hypertrophic lesions and post- burn lesions share some clinical features, yet few studies have directly compared their psychosocial repercussions within the same cohort. This study aimed to compare body acceptance and appreciation, anxiety, and depression in three groups of patients: burn scars, hypertrophic scars after surgery or incised-contused wounds, and keloidal lesions. The Body Appreciation Scale (BAS) is a validated instrument accepted across diverse cultural contexts, and was employed to assess body acceptance and appreciation. The Hospital Anxiety and Depression Scale (HADS), widely used in clinical populations with well-established psychometric properties, was the instrument used to assess anxiety and depression among the study patients. The combination of these instruments provides complementary frameworks for evaluating self-image and emotional health, key aspects for understanding the impact of skin alterations on patients’ overall quality of life.
CONCLUSION
The psychosocial impact of cutaneous lesions is multidimensional, with K, HL and PBL exhibiting broadly similar levels of body appreciation and emotional
distress. Emotional vulnerability among patients with PBL appeared more closely related to clinical features such as facial involvement and functional impairment than to the underlying cutaneous condition itself. These findings should be regarded as hypothesis-generating and require validation in larger, multicenter studies. Nevertheless, the high prevalence of borderline and probable anxiety symptoms across all groups supports the mandatory integration of routine psychosocial screening into the multidisciplinary management of Keloid Disorder and related dermatologic conditions.
Table 1. Univariate associations between combined anxiety and
depression, facial involvement and functional impairment (n=42).
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