Quality of life in Patients with Keloids in the Context of Marginalized identities: Pilot study and literature review – Abstract


Keloids are hyperproliferative scars that are most prevalent in African, Latinx and Asian populations and remain a significant burden on quality of life (QoL) as treatment can be difficult, painful and often unsuccessful. A pilot study was conducted at UConn Health to assess the results of clinical and psychosocial QoL impact surveys of 30 keloid patients. Results of this pilot study indicate that intersecting marginalized identities may increase the negative effects of keloids on patient QoL. Black female patients showed strong positive correlation of r=0.59 for number of keloids and number of symptoms reported (itching, painful, throbbing and burning), p < 0.10. A moderate positive correlation of r=0.46 was also found for Black female patients with the number of attempted keloid removals and number of negative feelings reported (worried, angry, sad and guilty). We also present a systematic review of the current keloid QoL literature to better understand questionnaire results in the context of intersecting marginalized identities and health disparities. Predefined criteria were used to identify and screen articles, within the period of March 2006 through May 2019, with a total of 10 articles that passed the criteria. A previously published intersectional analysis was utilized to analyze these keloid Qol studies to identify potential research disparities. Results of this intersectional analysis indicate that race and gender may add to a greater negative impact on keloid QoL in marginalized patients due to unacknowledged disparities in keloid QoL research studies. These results emphasize the need for greater inclusivity with regards to race and gender in keloid QoL questionnaires and studies to better assess keloid QoL impact on marginalized populations.

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