Systematic Review of Work-Related Burden and Psychosocial Impact of Immune-Mediated Skin Diseases

Conclusions

• Immune-mediated inflammatory skin diseases impose a meaningful and non-negligible burden on work productivity, work status, and working life.
• The work-related impact of these diseases is shaped not only by productivity loss but also by psychosocial distress, mental health effects, and stigma.
• Existing studies are heavily concentrated in psoriasis and other high-income Western settings, so the evidence does not yet represent the global skin-IMID population well.
• Validated work-impairment instruments such as WPAI, WLQ, and sick-leave measures are used inconsistently and do not capture all relevant domains.
• Current scores and questionnaires likely miss important stigma- and psychosocial-related aspects of work impact, limiting their usefulness.
• Patients with atopic dermatitis and hidradenitis suppurativa appear to experience particularly high work impairment in the available pooled data.
• Sick leave and presenteeism outcomes indicate that work loss occurs across multiple disease types and regions, but the evidence remains uneven and heterogeneous.
• A standardized, short, internationally applicable questionnaire is needed to measure work impact consistently across skin diseases and over time.
• Future research should include broader outcomes, more diverse populations, and multidisciplinary assessment to better quantify the true occupational burden.
• The findings support developing new tools and registries, such as the WAVE questionnaire, to improve measurement of skin-disease-related work impairment.