{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,23]],"date-time":"2026-08-23T17:35:14Z","timestamp":1787506514438,"version":"build-2736575974"},"reference-count":38,"publisher":"Oxford University Press (OUP)","issue":"5","license":[{"start":{"date-parts":[[2024,1,17]],"date-time":"2024-01-17T00:00:00Z","timestamp":1705449600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,4,17]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Vitiligo is the most common cause of skin depigmentation worldwide. Patients with vitiligo may experience stigma and this needs to be addressed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To evaluate stigma in patients with vitiligo, search for associated factors and establish severity strata for the Patient Unique Stigmatization Holistic tool in Dermatology (PUSH-D) for patients with vitiligo.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cross-sectional study in ComPaRe Vitiligo, an e-cohort of adult patients with vitiligo. Stigmatization was assessed using the PUSH-D, a recently validated dermatology-specific stigmatization assessment tool. We conducted univariate and multivariable linear regression to identify patient and disease factors associated with the stigmatization. We used an anchor-based approach to define severity strata for the PUSH-D.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In total, 318 patients participated (mean age 49.7\u2005years; 73.9% women). Fitzpatrick skin phototype IV\u2013VI, severe facial involvement (high Self-Assessment Vitiligo Extent Score of the face) and depression (high Patient Health Questionnaire-9 score) were positively \u00adassociated with a higher stigmatization score, although this association was weak [r = 0.24 (P &amp;lt; 0.001) and r = 0.30 (P &amp;lt; 0.001), respectively]. PUSH-D cutoff values that best discriminated patients with high and low stigma, as defined by the anchor question, were 13 and 23 (\u03ba = 0.622, 95% confidence interval 0.53\u20130.71).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Our study is the first to use a skin-specific stigmatization tool to assess stigma in patients with vitiligo. Creating strata helps to better interpret the PUSH-D in daily practice and may facilitate its use in clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/bjd\/ljae020","type":"journal-article","created":{"date-parts":[[2024,1,15]],"date-time":"2024-01-15T16:30:29Z","timestamp":1705336229000},"page":"712-717","source":"Crossref","is-referenced-by-count":18,"title":["Stigma in vitiligo: associated factors and severity strata of the Patient Unique Stigmatization Holistic tool in Dermatology (PUSH-D) score"],"prefix":"10.1093","volume":"190","author":[{"given":"Ali","family":"Fakih","sequence":"first","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Nord, Centre Hospitalier Universitaire, Universit\u00e9 Jean Monnet , Saint Etienne , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rim","family":"Tannous","sequence":"additional","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Henri Mondor, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne-Universit\u00e9 Paris , Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Lajnef","sequence":"additional","affiliation":[{"name":"Inserm U955 IMRB, Translational Neuropsychiatry Laboratory and Paris-Est Cr\u00e9teil University , Cr\u00e9teil , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julien","family":"Seneschal","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Reference Center for Rare Skin Disorders, H\u00f4pital Saint Andr\u00e9, Bordeaux , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolas","family":"Andreu","sequence":"additional","affiliation":[{"name":"Department of Dermatology, National Reference Center for Rare Skin Disorders, H\u00f4pital Saint Andr\u00e9, Bordeaux , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Viet-Thi","family":"Tran","sequence":"additional","affiliation":[{"name":"Center for Clinical Epidemiology, H\u00f4tel-Dieu Hospital (AP-HP) , Paris , France"},{"name":"Centre de Recherche \u00c9pid\u00e9miologie et Statistiques (CRESS), Universit\u00e9 de Paris , INSERM UMR1153, Paris , France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5468-4589","authenticated-orcid":false,"given":"Khaled","family":"Ezzedine","sequence":"additional","affiliation":[{"name":"Department of Dermatology, H\u00f4pital Henri Mondor, Universit\u00e9 Paris-Est Cr\u00e9teil Val de Marne-Universit\u00e9 Paris , Paris , France"},{"name":"EpidermE, Universit\u00e9 Paris-Est Cr\u00e9teil (UPEC) , Cr\u00e9teil , 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