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Chromy D, Urban N, Bauer WM, Kreuter A, Strassl R, Grabmeier-Pfistershammer K. Scars are frequently found as late sequelae in individuals affected by the 2022 mpox outbreak. HIV Med 2024. [PMID: 38816960 DOI: 10.1111/hiv.13678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2024] [Accepted: 05/17/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND The 2022 mpox outbreak continues, and while progress has been made in prevention strategies and potential treatment options, data on late sequelae following mpox are scarce. OBJECTIVE This analysis aimed to assess the incidence of scar formation in individuals affected by the 2022 mpox outbreak. METHODS All individuals diagnosed with mpox at the Department of Dermatology at the Medical University of Vienna in 2022 were included in this analysis. Follow-up data were collected throughout November 2023. 'Scar formation' was defined as having at least one scar at the former active mpox lesions. RESULTS At our clinic, 28 cases of mpox presented between June 2022 and October 2022 and exclusively occurred in men who have sex with men (100%, 28/28), of whom 46% (13/28) were living with HIV, and 32% (9/28) were using pre-exposure prophylaxis (PrEP). Secondary bacterial infection of mpox lesions was suspected in six individuals, and all received systemic antibiotics. Overall, 26 were followed up in November 2023 after a median time of 15 months, and scar formations were found in 43% of cases. CONCLUSIONS Our data provide insights into the late yet cumulating disease burden caused by the 2022 mpox outbreak. Highly effective prevention strategies are warranted to overcome the mpox epidemic and its potential late sequelae.
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Affiliation(s)
- David Chromy
- Department of Dermatology, Medical University of Vienna, Vienna, Austria
- Department of Dermatology and Venereology, University Hospital Essen, University Duisburg-Essen, Essen, Germany
| | - Nikolaus Urban
- Department of Surgery, Klinik Favoriten, Vienna Healthcare Group, Vienna, Austria
| | | | - Alexander Kreuter
- Department of Dermatology, Venereology and Allergology, Helios St. Elisabeth Hospital Oberhausen, University of Witten/Herdecke, Oberhausen, Germany
| | - Robert Strassl
- Division of Clinical Virology, Department of Laboratory Medicine, Medical University Vienna, Vienna, Austria
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Marsidi N, Ottevanger R, Demir YE, van Beugen S, Goeman JJ, Genders RE. Patient-reported outcome measurements in facial skin surgery and a comparison between Mohs micrographic surgery and conventional excisions. J Eur Acad Dermatol Venereol 2024. [PMID: 38644735 DOI: 10.1111/jdv.20025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Accepted: 02/28/2024] [Indexed: 04/23/2024]
Abstract
BACKGROUND Knowledge of the psychosocial impact of facial skin surgery on patients can help improve counselling strategies. OBJECTIVES The objective was to measure the psychological impact of facial skin cancer surgery on patients over a 1-year period. Secondary objective was to measure the difference between Mohs micrographic surgery (MMS) and conventional excision (CE) on these parameters. METHODS This observational survey study was conducted between March 2019 and July 2020. Patients who had facial skin surgery using MMS or CE were selected. Five surveys were conducted on four timepoints (preoperative, 1 week, 3 months and 1 year post-operative) measuring the quality of life, perceived stigmatization, body image, satisfaction with facial appearance and psychosocial distress. RESULTS A total of 228 patients (MMS 154 patients, CE 74 patients) were included for the analysis. Scores for quality of life did not significantly change, in the year after surgery (PCS-12 mean 50.5, SD 9.3 and MCS-12 50.6, SD 9.4); however, stigmatization (F (3, 235,39) 7,26, p < 0.01, d = -0.07), body image concerns (F (3, 198,28) = 3.75, p < 0.01, d = -0.14), satisfaction with facial appearance (F (3, 205,18) = 10.74, p < 0.01, d = 0.43) and psychosocial distress (F (3, 208,69) = 9.26, p < 0.01, d = -0.15) did change over time. The use of MMS or CE did not significantly affect outcome scores after 1 year. CONCLUSION Patients receiving facial skin cancer surgery exhibited low scores for perceived stigmatization and body image concerns. Their quality of life was not statistically influenced by facial surgery, and their satisfaction with their facial appearance and psychosocial distress even improved after 1 year. The results suggest that the surgical treatment type (MMS or CE) does not influence the outcome. The overall results can help in counselling strategies to improve expectations for patients receiving facial surgery.
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Affiliation(s)
- N Marsidi
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Dermatology, Ziekenhuisgroep Twente, Hengelo, The Netherlands
| | - R Ottevanger
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - Y E Demir
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
| | - S van Beugen
- Department of Health, Medical, and Neuropsychology, Institute of Psychology, Leiden University, Leiden, The Netherlands
| | - J J Goeman
- Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands
| | - R E Genders
- Department of Dermatology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Dermatology, Roosevelt Kliniek, Leiden, The Netherlands
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Alblowi YH, Alsaati AA, Alzubaidi AS, Alsifri SS, AlHarthi Y, Alotaibi MK. Prevalence and Causes of Stigmatization Among Patients With Chronic Skin Diseases in Saudi Arabia. Cureus 2024; 16:e59373. [PMID: 38817457 PMCID: PMC11139009 DOI: 10.7759/cureus.59373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/24/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Skin diseases can lead to stigmatization with negative consequences for patients' quality of life and mental health. AIM The aim of this study was to estimate the prevalence of stigmatization experienced by patients with vitiligo, psoriasis, acne, rosacea, or atopic dermatitis and to assess the relationships between the level of stigmatization and patient characteristics. METHODS This cross-sectional study included adult patients with vitiligo, psoriasis, acne, rosacea, or atopic dermatitis attending the dermatology clinics of various general hospitals in Saudi Arabia. Stigma levels were assessed using the six-item Stigma Scale. RESULTS The prevalence of stigmatization was 90.4% among the 280 patients included. Multiple regression analyses revealed the factors that independently and significantly increased the level of stigmatization. These included male gender (B = 4.300, 95%CI 3.407-5.192, P <0.001), positive family history of skin conditions (B = 2.267, 95%CI 1.139-3.395, P <0.001), number of skin diseases (B = 2.357, 95%CI 0.998-3.716, P = 0.001), and presence of facial lesions (B = 2.455, 95%CI 1.206-3.705, P<0.001). CONCLUSIONS The prevalence of stigmatization is high among patients with chronic skin diseases in Saudi Arabia. Identifying patients at risk for high levels of stigmatization may allow them to be provided with appropriate social and psychological support.
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Affiliation(s)
| | - Ahmed A Alsaati
- Department of Dermatology, College of Medicine, King Faisal University, Al-Hofuf, SAU
| | - Amirah Saleh Alzubaidi
- Department of Medicine and Surgery, College of Medicine, Umm Al-Qura University, Al-Qunfudhah, SAU
| | - Sahar Saud Alsifri
- Department of Dermatology, Faculty of Medicine, King Abdulaziz University, Jeddah, SAU
| | - Yousef AlHarthi
- Department of Dermatology and Dermatologic Surgery, Prince Sultan Military Medical City, Ministry of Defence, Riyadh, SAU
| | - Moteb Khalaf Alotaibi
- Department of Medicine, Unaizah College of Medicine and Medical Sciences, Qassim University, Unaizah, SAU
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4
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Szabó C. Bullying and skin diseases. J Eur Acad Dermatol Venereol 2024; 38:641-642. [PMID: 38523491 DOI: 10.1111/jdv.19793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 01/15/2024] [Indexed: 03/26/2024]
Affiliation(s)
- C Szabó
- Institute of Psychology, University of Szeged, Szeged, Hungary
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5
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Zeidler C, Kupfer J, Dalgard FJ, Bewley A, Evers AWM, Gieler U, Lien L, Sampogna F, Tomas Aragones L, Vulink N, Finlay AY, Legat FJ, Titeca G, Jemec GB, Misery L, Szabó C, Grivcheva Panovska V, Spillekom van Koulil S, Balieva F, Szepietowski JC, Reich A, Ferreira BR, Lvov A, Romanov D, Marron SE, Gracia Cazaña T, Elyas A, Altunay IK, Thompson AR, van Beugen S, Ständer S, Schut C. Dermatological patients with itch report more stress, stigmatization experience, anxiety and depression compared to patients without itch: Results from a European multi-centre study. J Eur Acad Dermatol Venereol 2024. [PMID: 38468596 DOI: 10.1111/jdv.19913] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/23/2024] [Indexed: 03/13/2024]
Abstract
BACKGROUND Itch as the most common symptom in dermatology has been shown to be related to psychological factors such as stress, anxiety and depression. Moreover, associations were found between perceived stigmatization and itch. However, studies investigating the differences between patients with dermatoses with and without itch regarding perceived stress, stigmatization, anxiety and depression are missing. Therefore, one of the aims of the second study of the European Society for Dermatology and Psychiatry (ESDaP study II) was to investigate these relationships in a large cohort of patients with different itchy dermatoses. RESULTS 3399 patients with 14 different itchy dermatoses were recruited at 22 centres in 17 European countries. They filled in questionnaires to assess perceived stigmatization, stress, signs of clinically relevant anxiety or depression, itch-related quality of life, the overall health status, itch duration, frequency and intensity. The most significant association between the severity of itching and the perception of stress was observed among individuals with rosacea (correlation coefficient r = 0.314). Similarly, the strongest links between itch intensity and experiences of stigmatization, anxiety, and depression were found in patients with seborrheic dermatitis (correlation coefficients r = 0.317, r = 0.356, and r = 0.400, respectively). Utilizing a stepwise linear regression analysis, it was determined that within the entire patient cohort, 9.3% of the variation in itch intensity could be accounted for by factors including gender, levels of anxiety, depression, and perceived stigmatization. Females and individuals with elevated anxiety, depression, and perceived stigmatization scores reported more pronounced itch intensities compared to those with contrary attributes. CONCLUSION This study underscores the connection between experiencing itch and its intensity and the psychological strain it places on individuals. Consequently, psychological interventions should encompass both addressing the itch itself and the interconnected psychological factors. In specific cases, it becomes imperative for dermatologists to direct individuals towards suitable healthcare resources to undergo further psychological assessment.
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Affiliation(s)
- C Zeidler
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - J Kupfer
- Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany
| | - F J Dalgard
- Division of Mental Health and Addiction, Vestfold Hospital Trust, Tønsberg, Norway
- Department of Dermatology and Venereology, Skåne University Hospital, Malmo, Sweden
| | - A Bewley
- Barts Health NHS Trust & Queen Mary University of London, London, UK
| | - A W M Evers
- Faculty of Social and Behavioural Sciences, Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | | | - L Lien
- Faculty of Social and Health Sciences, Inland Norway University of Applied Sciences, Elverum, Norway
- Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Innlandet Hospital Trust, Brumunddal, Norway
| | - F Sampogna
- Clinical Epidemiology Unit, IDI-IRCCS, Rome, Italy
| | - L Tomas Aragones
- Department of Psychology, University of Zaragoza, Zaragoza, Spain
- Aragon Psychodermatology Research Group Zaragoza, Zaragoza, Spain
| | - N Vulink
- Department of Psychiatry, Amsterdam UMC, Location Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
| | - A Y Finlay
- Division of Infection and Immunity, School of Medicine, Cardiff University, Cardiff, UK
| | - F J Legat
- Department of Dermatology, Medical University of Graz, Graz, Austria
| | - G Titeca
- Clinique Notre Dame de Grâce, Gosselies, Belgium
| | - G B Jemec
- Department of Dermatology, Zealand University Hospital, Roskilde, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - L Misery
- Department of Dermatology, University Hospital of Brest, Brest, France
| | - C Szabó
- Institute of Psychology, University of Szeged, Szeged, Hungary
| | - V Grivcheva Panovska
- School of Medicine, PHI University Clinic of Dermatology, University St Cyril and Methodius, Skopje, North Macedonia
| | - S Spillekom van Koulil
- Radboud Institute for Health Sciences, Department of Medical Psychology, Radboud University Medical Centre, Nijmegen, The Netherlands
| | - F Balieva
- Department of Dermatology, Stavanger University Hospital, Stavanger, Norway
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - J C Szepietowski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, Wroclaw, Poland
| | - A Reich
- Department of Dermatology, Institute of Medical Sciences, Medical College of Rzeszów University, Rzeszów, Poland
| | - B R Ferreira
- Centre for Philosophy of Science of the University of Lisbon, Lisbon, Portugal
- Department of Dermatology, Coimbra Hospital and University Centre, Portugal
- University of Brest, Lien, France
| | - A Lvov
- Central State Medical Academy of Department of Presidential Affairs, Moscow, Russia
- Medical Research and Educational Centre, Lomonosov Moscow State University, Moscow, Russia
| | - D Romanov
- Department of Psychiatry and Psychosomatics, I.M. Sechenov First Moscow State Medical University (Sechenov University), Moscow, Russia
- Department of Boundary Mental Conditions and Psychosomatic Disorders, Mental Health Research Centre, Moscow, Russia
- International Institute of Psychosomatic Health, Moscow, Russia
| | - S E Marron
- Aragon Psychodermatology Research Group Zaragoza, Zaragoza, Spain
- Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain
| | - T Gracia Cazaña
- Department of Dermatology, University Hospital Miguel Servet, Zaragoza, Spain
| | - A Elyas
- Department of Dermatology, Skåne University Hospital, Malmö, Sweden
| | - I K Altunay
- Şişli Hamidiye Etfal Training and Research Hospital, Dermatology and Venereology Clinic, University of Health Sciences, Istanbul, Turkey
| | - A R Thompson
- South Wales Clinical Psychology Training Programme, Cardiff & Vale University Health Board & School of Psychology, Cardiff University, Cardiff, UK
| | - S van Beugen
- Faculty of Social and Behavioural Sciences, Institute of Psychology, Unit Health, Medical and Neuropsychology, Leiden University, Leiden, The Netherlands
| | - S Ständer
- Department of Dermatology and Center for Chronic Pruritus, University Hospital Münster, Münster, Germany
| | - C Schut
- Institute of Medical Psychology, Justus-Liebig-University, Gießen, Germany
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Christensen RE, Jafferany M. Unmet Needs in Psychodermatology: A Narrative Review. CNS Drugs 2024; 38:193-204. [PMID: 38386200 DOI: 10.1007/s40263-024-01068-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/07/2024] [Indexed: 02/23/2024]
Abstract
Psychodermatology, the multidisciplinary field that explores the intricate interplay between the mind and the skin, has gained increasing recognition over the past decade. However, several knowledge gaps and unmet needs persist in the field. The objective of this narrative review was to investigate the unmet needs in the field of psychodermatology as they pertain to medical training, treatment, research, and care access. PubMed was searched from inception through December 2023 to identify articles related to psychodermatology. Findings revealed several unmet needs within the field of psychodermatology. First, there is a need for further investigation into the pathophysiology that links psychological stress to cutaneous disease including the development of novel therapies targeting key neuropeptides. Second, the existing literature focuses primarily on the pharmacologic treatment of body dysmorphic disorder and body-focused repetitive behaviors, as well as delusional parasitosis, for which the first-line agents are selective serotonin reuptake inhibitors and atypical antipsychotics, respectively. However, additional research into the efficacy and safety of the remaining psychotropic medications and the treatment of other common psychocutaneous diseases is required. Finally, there exists a significant gap in knowledge amongst clinicians tasked with treating psychocutaneous diseases. Dermatologists report low rates of training in psychodermatology and discomfort with prescribing psychotropic medications. In conclusion, increasing resources for dermatologist education on psychotropic agent use, development of new drugs targeting stress-induced skin conditions, and research on the psychocutaneous applications of current medications may greatly improve the quality and access of psychodermatology care.
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Affiliation(s)
- Rachel E Christensen
- Department of Psychiatry and Behavioral Sciences, Central Michigan University College of Medicine/CMU Medical Education Partners, Saginaw, MI, 48603, USA
- Department of Dermatology, Northwestern Feinberg School of Medicine, Chicago, IL, 60611, United States
| | - Mohammad Jafferany
- Department of Psychiatry and Behavioral Sciences, Central Michigan University College of Medicine/CMU Medical Education Partners, Saginaw, MI, 48603, USA.
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Szepietowska M, Stefaniak AA, Krajewski PK, Matusiak L. Females May Have Less Severe Acne, but They Suffer More: A Prospective Cross-Sectional Study on Psychosocial Consequences in 104 Consecutive Polish Acne Patients. J Clin Med 2023; 13:4. [PMID: 38202011 PMCID: PMC10779808 DOI: 10.3390/jcm13010004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2023] [Revised: 12/13/2023] [Accepted: 12/15/2023] [Indexed: 01/12/2024] Open
Abstract
Acne is a common skin condition affecting both adolescents and adults, and it can profoundly impact patients' quality of life and mental well-being. This prospective cross-sectional study aims to explore the differences in psychosocial aspects between male and female acne patients in Poland. A total of 104 consecutive acne patients were included in this study. Clinical severity, patients' quality of life, stigmatization levels, and psychiatric disturbances were evaluated using the following instruments: Investigator Global Assessment (IGA), Dermatology Life Quality Index (DLQI), Cardiff Acne Disability Index (CADI), 6-Item Stigmatization Scale (6-ISS), and Hospital Anxiety and Depression Scale (HADS). This study found that female patients exhibited significantly less severe acne and experienced significantly decreased quality of life and increased levels of stigmatization. Furthermore, anxiety levels among female patients exceeded those observed in their male counterparts. Notably, no disparities in the severity of depression were observed between the two gender groups. Correlations were discerned among all psychosocial parameters in the entire study cohort and in the female subgroup, while such correlations were not uniformly observed among male participants. This study underscores the importance of considering psychosocial aspects and implementing routine measurements in the management of acne to improve patients' well-being.
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Affiliation(s)
| | | | - Piotr K. Krajewski
- Department of Dermatology, Venereology and Allergology, Wroclaw Medical University, 50-368 Wroclaw, Poland; (M.S.); (A.A.S.); (L.M.)
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8
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Eleftheriadou V, Thompson AR. Skin is a window to one's inner world. Br J Dermatol 2023; 189:501-502. [PMID: 37624845 DOI: 10.1093/bjd/ljad300] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Revised: 08/01/2023] [Accepted: 08/02/2023] [Indexed: 08/27/2023]
Affiliation(s)
- Viktoria Eleftheriadou
- Dermatology, Royal Wolverhampton NHS Trust, Wolverhampton, UK
- Institute of Applied Health Research, College of Medical and Dental Sciences, University of Birmingham
| | - Andrew R Thompson
- South Wales Clinical Psychology Training, Cardiff and Vale University Health Board, Cardiff, UK
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Munz J, Kupfer J, Schepko M, Weisshaar E, Schut C. [Stigmatization and social anxiety in patients with skin diseases]. DERMATOLOGIE (HEIDELBERG, GERMANY) 2023; 74:799-808. [PMID: 37721562 DOI: 10.1007/s00105-023-05219-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 08/07/2023] [Indexed: 09/19/2023]
Abstract
Stigmatization of patients with skin diseases has only recently attracted more attention in research. However, both external stigmatization by society and self-stigmatization by the affected patients are widespread in patients with skin diseases. Many studies show that in this group of patients, the experience of both kinds of stigmatization is associated with psychosocial burden, such as social anxiety. This is often independent of the visibility of skin lesions. The psychosocial burden of affected individuals may lead to psychological comorbidities, such as depression or anxiety disorders, making it important to screen patients in dermatologic settings for the presence of these conditions. Interventions to reduce external and self-stigmatization have been developed, but more randomized controlled trials are needed to test the effects of such interventions.
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Affiliation(s)
- J Munz
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland.
| | - J Kupfer
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - M Schepko
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
| | - E Weisshaar
- Sektion Berufsdermatologie, Zentrum Hautklinik, Universitätsklinikum Heidelberg, Heidelberg, Deutschland
| | - C Schut
- Institut für Medizinische Psychologie, Justus-Liebig-Universität Gießen, Gießen, Deutschland
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