Table 5.
Details of reviewed studies about birthmarks, according to location, sample, method design and significant outcomes
| Setting | Method | Results | Study quality | ||||||
|---|---|---|---|---|---|---|---|---|---|
| Ref | Location | N | Design | Tools | Comparator(s) | IV(s) | DV(s) | Significant outcomes | |
| Wang et al. [102] | China | 197 | Cross-sectional—quantitative (moderate) | Questionnaire (DLQI) | 196 vitiligo subjects | PWS characteristics | Skin-disease-specific QoL |
PWS patients QoL↓ vs. vitiligo patients (esp. feelings, daily activities, leisure, work/school, treatment)*** QoL↓ ← ♀; hypertrophy↑; size of skin lesion↑* |
High |
| Hagen et al. [101] | USA | 244 | Cross-sectional—quantitative (low) | Questionnaire (Skindex-29; OGs) | 14 other skin conditions extracted from previous studies | Socialization w/ others; medical comorbidities; PWS severity; treatments | Skin-disease-specific QoL |
Anxiety & depression: most reported comorbidities and associated w/ impact on QoL↑*** QoL ↔ comorbid depression**, limited facial mobility**, presence of other skin conditions* Emotional impairments↓ ↔ older patients**, patients from educationnal services*** PWS hypertrophy ↔ emotional↑* & symptomatic↑*** impairments Functional impairments↓ ↔ close friends↑* & social engagements↑* PWS patients: QoL↓ vs. non-affected subjects (but similar to CTCL, rosacea, alopecia & vitiligo) |
Moderate |
| Augustin et al. [132] | Germany | 70 | Cross-sectional—quantitative (low) | Dermatologist's clinical assessment; Questionnaires (SCL-53R; ALLTAG; CSDQ; FKS; OGs) | 1006 non-affected subjects (extracted from another study) | Skin-specific coping; impact of PWS; global QoL limitations | Emotional well-being; body image |
PWS patients: emotional well-being↓ (interpersonal sensitivity***, anxiety**, hostility**, phobic anxiety**, paranoid ideation**); body perception↓ (attractiveness/self-confidence*); QoL↓ (social relationship*) vs. non-affected subjects Body perception & emotional well-being ↔ physical malaise* |
High |
| Ben-Tovim & Walker, [131] | Australia | 52 (including about 5 adolescents) | Cross-sectional—quantitative (moderate) | Questionnaires (BAQ) | 49 rheumatoid arthritis; 23 eczema/psoriasis; 50 type 1 diabetes; 174 non-affected subjects | Body informations (height, weight, BMI) | Body-related attitudes | BVD patients: body-related attitudes impacted (strength/fitness↑*; salience of weight/shape↓*) | Moderate |
| Lanigan & Cotterill, [130] | England | 71 (including about 5 adolescents) | Cross-sectional—quantitative (low) | Questionnaires (GHQ; HADS; OGs) | N/A | PWS characteristics | General health; Emotional state; Attitudes toward their PWS |
No significant impact of PWS on emotional or psychiatric state Social difficulties in PWS patients: dealing with strangers' reactions; need to hide the mark or treat it; impact on self-confidence; feeling different from others; feeling unattractive |
Moderate |
| Malm & Carlberg, [133] | Sweden | 23 | Exploratory -qualitative (low) | Structured interviews | N/A | N/A | N/A |
Patients with Large PWS: dealing with strangers' reactions (emotionally difficult); family as a source of support; childhood's bad experiences; very different coping in social contexts (withdrawall, taunt, humor); mark-hiding techniques (make-up) Patients with Small PWS: mark-hiding techniques (make-up); dealing with strangers' (paranoid anxiety about PWS); exaggerated self-consciousness about the PWS |
Low |
All study considered socio-demographic aspects (for example: age; gender; education lvl; socio-economic status; profession; etc.)
IV Independent variable; DV Dependent variable; GTM Grounded theory methodology; TCA Thematic content analysis; PWS Port-wine-stains; CTCL Cutaneous T-cell lymphoma; BVD Blood vessel disorders; MLR Multiple linear regression; pop Population
A ↔ B: A is associated with B; A → B: A predicts B; A↑: A is higher/more important; A↓: A is lower/less important; with: w/; without: w/o; vs.: compared to…
p < 0.05*; p < 0.01**; p < 0.001***