Mapping the global work-related impact of immune-mediated inflammatory skin diseases: A systematic review.

Immune-mediated inflammatory diseases (IMIDs) of the skin can significantly affect individuals' work functioning and pose societal challenges. This systematic review examined the burden of common skin IMIDs (alopecia areata, atopic dermatitis, hidradenitis suppurativa, psoriasis, vitiligo) on work outcomes. Eight databases (PubMed, Web of Science Core Collection, Embase, SciELO, KCI Korean Journal Database, Global Index Medicus, Informit, and Google Scholar) were searched through June 2024. Eligible studies included adults with 1 of these IMIDs and quantitative designs (trials, cohorts, case-control, or cross-sectional studies) reporting work outcomes. From 8176 records, 196 studies were included. Sample sizes ranged from small (n = 28) to nationwide (n = 2,638,681) datasets. Psoriasis (56.12%) and atopic dermatitis (31.12%) dominated, mainly from Europe (54.08%). Most studies (92.35%) assessed productivity and predominantly used validated tools. The evidence shows that skin IMIDs affect multiple work domains, extending beyond productivity loss to psychosocial factors, such as burnout or employment status. Heterogeneity in measurement methods limits external validity. Research gaps persist for rarer IMIDs and low- to middle-income settings, particularly sub-Saharan Africa (only 0.51%). The evidence indicates a substantial effect of skin IMIDs on work, yet consensus on work-related outcomes is lacking. Greater conceptual clarity is needed to understand their impact on employment and support sustainable work participation.