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Publications

Journal Article Review Ahead of print

PubMed: 42573445 DOI: 10.1111/jdv.70653

Work impact of immune-mediated inflammatory skin diseases: A systematic review and meta-analysis.

J Eur Acad Dermatol Venereol

Authors: Fanny C Kpenou, Ju Hee Han, Marc Fadel, Tat-Thang Vo, Hyun Jeong Ju, Tarik El Aarbaoui, Christopher E M Griffiths, Henry W Lim, Lars E French, Carsten Flohr, Suzanne H Keddie, Rosa Parisi, Gregor B E Jemec, Jennifer Kilmer, Darren M Ashcroft, Maria Hordinsky, Viktoria Eleftheriadou, Esther Freeman, L Claire Fuller, Jung Min Bae, Viet-Thi Tran, Alexis Descatha, Khaled Ezzedine

Affiliations

  • Epidemiology in Dermatology and Evaluation of Therapeutics (EpiDermE), IMRB - INSERM U955, Paris-Est Créteil University, Créteil, France.
  • Public Health Doctoral Network (RDSP), École des Hautes Études en Santé Publique (EHESP), Rennes, France.
  • Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • UMR_S 1085, Equipe ESTER, SFR ICAT, CAPTV/Prévention, Univ Angers, CHU Angers, Univ Rennes, Inserm, EHESP, Irset (Institut de recherche en santé, environnement et travail), Angers, France.
  • Department of Dermatology, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
  • Department of Dermatology, King's College Hospital, King's College London, London, UK.
  • Global Psoriasis Atlas, University of Manchester, Manchester, UK.
  • Department of Dermatology, Henry Ford Health, Detroit, Michigan, USA.
  • Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany.
  • Department of Dermatology and Cutaneous Surgery, School of Medicine, University of Miami Miller, Miami, Florida, USA.
  • Global Atopic Dermatitis Atlas Coordinating Centre, St John's Institute of Dermatology, Guy's & St Thomas' NHS Foundation Trust and King's College London, London, UK.
  • Division of Informatics, Imaging and Data Sciences, School of Health Sciences, Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK.
  • Department of Dermatology, Zealand University Hospital, Roskilde, Denmark.
  • Department of Clinical Medicine, Faculty of Health and Medical Science, University of Copenhagen, Copenhagen, Denmark.
  • European Hidradenitis Suppurativa Foundation, Dessau, Germany.
  • International League of Dermatological Societies (ILDS), London, UK.
  • Division of Pharmacy and Optometry, School of Health Sciences, Faculty of Biology, Medicine & Health, University of Manchester, Manchester, UK.
  • Department of Dermatology, University of Minnesota Medical School, Minneapolis, Minnesota, USA.
  • Dermatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK.
  • Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK.
  • Department of Dermatology, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
  • International Foundation for Dermatology, London, UK.
  • Department of Dermatology, London Bridge Hospital, London, UK.
  • Center for Research in Epidemiology and Statistics (CRESS), Inserm, INRAE, Université Paris Cité and Université Sorbonne Paris Nord, Paris, France.
  • Department of Clinical Epidemiology, Hôtel-Dieu University Hospital, Assistance Publique - Hôpitaux de Paris, Paris, France.
  • Indiana University School of Public Health, Bloomington, Indiana, USA.
  • Donald and Barbara Zucker School of Medicine, Hofstra Univ Northwell Health, Hempstead, New York, USA.
  • Department of Dermatology, Henri-Mondor University Hospital, Assistance Publique - Hôpitaux de Paris, Créteil, France.

Abstract

BACKGROUND

Patients with immune-mediated inflammatory diseases (IMIDs) of the skin face challenges beyond visible signs. Despite their significant psychosocial burden, the global impact of skin IMIDs on work productivity has not been systematically reviewed.

OBJECTIVE

To evaluate the global burden of skin IMIDs on work productivity.

METHODS

We conducted a systematic review and meta-analysis. Eight electronic databases (PubMed, Web of Science Core Collection, Embase, SciELO, KCI Korean Journal Database, Global Index Medicus, Informit and Google Scholar) were searched from inception to June 2024. We included quantitative studies reporting work-related outcomes in adults (≥18 years) with alopecia areata, atopic dermatitis, hidradenitis suppurativa, psoriasis or vitiligo. For the meta-analysis, studies had to report Work Productivity and Activity Impairment (WPAI), Work Limitations Questionnaire (WLQ) or sick leave duration. Two reviewers independently screened and extracted data. Risk of bias was assessed using validated tools. Data were pooled using frequentist and Bayesian approaches to ensure estimations robustness across heterogeneous designs and sample sizes.

RESULTS

Across 100 studies with a cumulative sample of 306,619 participants worldwide, skin IMIDs were consistently associated with impaired work functioning. Notably, the mean WPAI overall work impairment was 28.96 (95% CI 25.61; 32.31), and participants averaged 16.74 days of sick leave per year (95% CI 7.39; 26.1). Findings suggest that occupational impairment was influenced by psychosocial factors, thereby highlighting broader societal and economic consequences.

CONCLUSION

Skin IMIDs substantially reduce work functioning and productivity worldwide, representing an underrecognized burden on individuals, employers and health systems. Better multidisciplinary strategies are needed to prevent occupational disadvantage and mitigate the economic and social impact of these chronic conditions.

MeSH

Skin, Sexually Transmitted Diseases, Alopecia Areata, Sick Leave, Vitiligo, Hidradenitis Suppurativa, Skin Diseases, Signs And Symptoms, Work, Psoriasis, Dermatitis, Atopic