Psoriasis is a chronic, immune-mediated inflammatory disease characterized by recurring flare-ups over a prolonged period.1 Its prevalence varies globally, affecting 125 million people worldwide.2–4 Psoriasis patients often face a significant psychological burden that can surpass the physical symptoms.5,6 It is well-documented that there is an increased incidence of psychiatric disorders such as depression, suicidal ideation, anxiety, sexual dysfunctions, and alcohol dependency in affected individuals.7–10 Moreover, psoriasis patients often receive less social support and may experience greater stigmatization compared to individuals with other dermatological conditions, especially when lesions are located in visible areas such as the face, scalp, and hands.11–14 Social experiences, including exclusion, feelings of worthlessness, rejection, and difficulties in daily life, further exacerbate the impact of psoriasis on patients.

Given the high burden of psoriasis and its negative impact on quality of life, the World Health Organization (WHO) has classified it as a noncommunicable disease of particular importance. In line with WHO recommendations, psoriasis should be regarded with the same level of priority as cancer, cardiovascular diseases, diabetes mellitus, and chronic lung diseases in terms of health services. WHO also advocates for efforts to reduce the stigmatization associated with psoriasis and to raise awareness about the disease.15 Additionally, ensuring better access to guideline-based health services for individuals diagnosed with psoriasis is one of the requirements of the United Nations' 2015–2030 Sustainable Development Goals.16

Misconceptions about psoriasis can negatively influence attitudes towards individuals diagnosed with psoriasis.17,18 Studies conducted in different countries have revealed that a lack of knowledge about psoriasis leads to negative attitudes towards affected individuals.17,19–21 Health literacy in Turkiye, similar to other underdeveloped countries, is known to be low, and this may further exacerbate negative attitudes toward psoriasis patients.22 Moreover, identifying the factors that shape attitudes toward psoriasis is crucial, yet there are limited studies on this topic in these countries. This study aims to evaluate the attitudes, knowledge levels, and associated factors regarding psoriasis among adults in a community-based sample.

The present study demonstrated a moderate level of positive societal attitudes towards psoriasis, which were influenced by the participants' knowledge levels. Attitude is defined as a fictional structure representing the degree of liking or disliking of an individual towards a certain attitude object. People's attitude towards a certain attitude object (psoriasis patient) is the positive or negative views that develop towards that object as a result of the integration of thought, emotion and behavioral tendency. It is known that attitudes can be cognitive or affective.24 The individual's positive and negative information helps to make decisions about a subject. A positive societal attitude towards psoriasis patients is important as it can reduce the stigmatization of these individuals and lessen the psychological burden of the disease.

It is expected that an adequate level of knowledge about psoriasis in society will reduce misinformation and beliefs about the disease. In this study, the frequency of hearing about psoriasis before in the Turkish language was found to be 78.7% while the frequency of hearing about psoriasis as a term in medical terminology was found to be 17.3%. In the study conducted by Sommer et al., it was reported that 80% of the participants had heard about psoriasis in the German language, while 20% of the participants had heard about the term “psoriasis”.20 In the study of Assiri et al., 79% of the study participants had heard about psoriasis in the Arabic language.25 It is expected that diseases are known in the local language rather than by their medical terminology. This situation is important in terms of showing that efforts to increase psoriasis literacy in society should be based more on the use of the local language.

In the present study, approximately 60% of participants did not have an adequate level of knowledge about psoriasis. Misconceptions such as psoriasis being a contagious disease (45.8%), caused by a lack of hygiene (49.4%), or transmitted by shaking hands (43.4%) may contribute significantly to the stigmatization of patients. Similarly, a study by Halioua et al. In France reported that 62.4% of the general population lacked knowledge about psoriasis.26 In a study by Alzolibani in Saudi Arabia, 45.6% of respondents were unaware of whether psoriasis was contagious or not.17 These findings highlight that inadequate knowledge about psoriasis is a widespread issue across different societies.

Positive attitudes towards psoriasis can help reduce the severity of the disease by reducing psychological stress and improving treatment outcomes.27,28 First of all, the reliability and validity of the Psoriasis Attitude Scale were tested in this study. Based on these results, the Psoriasis Attitude Scale promised a reliable and valid measurement tool for the Turkish population.29 It is noteworthy that 49.4% of the participants scored above the average on the Psoriasis Attitude Scale. Additionally, it was determined that they showed a moderately positive attitude towards psoriasis. In Malaysia, Yong et al. reported at least one misconception towards psoriasis in 64.6% of participants.30 Similarly, in a study assessing the perception and stigmatization of people with psoriasis in Germany, it was reported that 59% of the general population had a negative attitude towards people diagnosed with psoriasis.20 The varied results in these studies may be explained by using different measurement tools in different cultural societies.20,30

In the present study, when examining predictors of attitudes toward psoriasis, educational level and employment in an income-generating job were considered indicators of social status. The authors found that the attitude towards psoriasis was more negative in those participants with lower educational levels. Low educational status may indirectly lead to an inadequate knowledge level and awareness about psoriasis. However, in a study by Almutairi et al., no significant difference was found between educational status and attitudes toward psoriasis.31 Other studies have also reported that people's attitudes towards psoriasis are not affected by higher educational levels.17,32 Additionally, in this study, a more positive attitude towards psoriasis was found in those who worked in a job that generated income. In contrast, Assiri et al. reported that no significant difference was found between working in a job that generated income and attitudes towards psoriasis.25 There are also other studies in the literature that reported no difference between working in a job that generated income and attitudes towards psoriasis.31,33 In fact, it can be expected that individuals' attitudes towards differences will be more positive as their interaction with their environment increases in their working lives. The different results presented in the studies may be due to the differences in the educational systems and working environments in the countries and the differences in the measurement tools used.

The present study revealed that those who have a family member diagnosed with psoriasis showed a more positive attitude towards psoriasis. It is predicted that those who are exposed to such health conditions could empathize and also have a more positive attitude towards the situation. Numerous studies have shown that individuals with acquaintances who have skin diseases tend to have a more positive outlook and a higher level of knowledge about the condition.20,33–35 It has also been reported that those who have a history of personal contact with a psoriatic patient have a more positive attitude towards the disease.17

Approximately 40% of these participants had an adequate knowledge level about psoriasis, and about half showed a positive attitude according to the Psoriasis Attitude Scale. To assess the attitudes toward psoriasis, the authors tested the reliability and validity of the Psoriasis Attitude Scale. It can be used in future studies and may help establish standardization in measuring attitudes across different research. The present study revealed that the most significant predictor of attitudes toward psoriasis was the adequacy of knowledge. This finding suggests that educational interventions and efforts to raise public awareness about psoriasis, particularly by addressing common misconceptions, could play a crucial role in reducing stigmatization.

Esra Ağaoğlu: 0000-0001-8985-6224

Bengisu Karagöz: 0009-0007-2092-2044

Hilal Kaya Erdoğan: 0000-0002-8172-1920

Muhammed Fatih Önsüz: 0000-0001-7234-3385

Selma Metintaş: 0000-0002-5002-5041

None declared.

Erman Kavlu: Conceptualization; data curation; formal analysis; investigation; software; visualization; writing-original draft.

Esra Ağaoğlu: Conceptualization; investigation; methodology; writing-original draft; review & editing.

Bengisu Karagöz: Conceptualization; data curation; formal analysis; investigation; software; visualization; writing-original draft.

Hilal Kaya Erdoğan: Conceptualization; investigation; methodology; validation.

M. Fatih Önsüz: Conceptualization; investigation; methodology; resources.

Selma Metintaş: Conceptualization; formal analysis; methodology; project administration; validation; writing-original draft; review & editing.

The entire dataset supporting the results of this study was published in this article.

None.