Psychological impact and quality of life in pediatric patients with chronic skin disorders: a systematic review (2010-2025).

INTRODUCTION

Chronic skin disorders in children and adolescents are increasingly recognized as conditions with significant psychosocial implications. Beyond physical manifestations, these diseases adversely affect psychological well-being, health-related quality of life (HRQoL), and family functioning.

METHODS

A systematic review was conducted following PRISMA guidelines. Five electronic databases were searched for studies published between 2010 and 2025. Empirical studies assessing psychological outcomes or HRQoL among pediatric patients (≤18 years) with chronic dermatologic conditions were included. Methodological quality was appraised using JBI and CASP tools. Due to heterogeneity in study designs and outcome measures, findings were synthesized narratively.

RESULTS

A total of 1,844 records were identified, with 41 studies meeting inclusion criteria. Most studies were cross-sectional (approximately 75%), with 12 classified as high methodological quality. Sample sizes ranged from fewer than 10 to over 11,000 children. Across conditions including atopic dermatitis, psoriasis, vitiligo, alopecia areata, hidradenitis suppurativa, and congenital ichthyosis, elevated rates of anxiety, depression, stigma, and emotional distress were consistently reported. Severe atopic dermatitis was associated with nearly a two-fold increased risk of depressive and internalizing symptoms in longitudinal data. HRQoL impairment commonly affected emotional functioning, peer relationships, school participation, and sleep. Caregiver burden was documented in 19 studies.

DISCUSSION: Findings highlight the multidimensional burden of pediatric chronic skin disease, where psychosocial distress often parallels physical symptom severity.

CONCLUSION

Chronic skin disorders are consistently associated with psychological distress and reduced HRQoL. Causal inferences cannot be drawn given cross-sectional designs; findings support routine psychosocial assessment and family-centered care to improve outcomes.