Perception of aesthetic impairment in patients with systemic sclerosis using a semi-quantitative scale and association with disease characteristics.

Abstract

Background: Systemic sclerosis (SSc) is a fibrotic disease. Assessment of body image could be central in optimizing care. Yet, data are scarce. The main objective was to assess perception of aesthetic impairment using a visual aesthetic scale (AES) in patients with SSc compared to healthy subjects. Secondary objectives were to assess associations between perception of aesthetic impairment and standardized questionnaires for aesthetic impairment as well as clinical, psychological/quality of life, and functional parameters of SSc. Methods: This study evaluated and compared perception of aesthetic impairment in two populations: patients with SSc, in a referral center at Lille Hospital, France, and healthy controls. Results: This study included 88 patients (69 [78.4%] women) with a median age of 52 years and 88 controls (49 [55.7%] women) with a median age of 45 years. Perception of aesthetic impairment assessed using the AES was poorer in patients than in controls (3.7 ± 0.3 vs 2.8 ± 0.3, p=0.028), with statistical correlation with ASWAP, a specific aesthetic impact assessment questionnaire for patients with SSc. Patients with anxiety or depressive symptoms had significantly higher AES scores. SSc patients with facial involvement and pitting scars had a worse perception of aesthetic impairment. SSc patients have a worse perception of aesthetic impairment than healthy controls, especially in SSc patients with anxiety or depression and those with facial and hand involvement. Conclusion: The AES appears to be an ease of use tool to evaluate body image. Correlations found with psychological and quality of life parameters reflect the importance of these parameters for body image evaluation and its complex assessment. Trial registration: Clinical Trial NCT03271320. Registered 09 January 2017, https://www.clinicaltrials.gov/ct2/show/NCT03271320?term=NCT03271320&cntry=FR&draw=2&rank=1