A pilot study of body image dissatisfaction and the psychological impact of systemic sclerosis-related telangiectases

Objectives. To determine the extent of body image dissatisfaction (BID) in patients with self-reported systemic sclerosis (SSc)-related telangiectases and to identify the demographic, psychological and disease-related correlates of BID within a cross-sectional study. Methods. Patients with SSc were invited to participate in a questionnaire survey. Each completed the Adjusted Satisfaction with Appearance Scale (ASWAP), the Hospital Anxiety and Depression Scale (HADS) and an open-ended telangiectases questionnaire. Thematic analysis was utilised to describe the qualitative data. Results. 141 patients with SSc participated (83% female, 70% limited cutaneous SSc, median age 62 years). Telangiectases were reported by 113 (80%). ASWAP 'dissatisfaction with appearance' scores were significantly higher in those reporting telangiectases (p=0.02). Anxiety and depression scores were similar in those with and without telangiectases. Those reporting telangiectases were more likely to be anticentromere positive (40% vs. 18%, p=0.02) and to have a history of severe digital ischaemia (38% vs. 18%, p=0.04) than those not. Qualitative analysis revealed four themes: changes in behaviour as a-result of telangiectases, public and private self-image, negative emotional impact of telangiectases and appreciation of life. Conclusions. BID, as measured by the ASWAP 'dissatisfaction with appearance' subscale, was significantly higher in patients with telangiectases. Telangiectases were associated with anticentromere positivity and digital ischaemia, lending further support for telangiectases as a potential marker for vascular involvement. Qualitative analysis provided new insights into the thoughts and feelings of patients with telangiectases. Our findings highlight the impact of telangiectases and the need to address and manage related concerns.