OBJECTIVES: Most dermatological conditions fall under visible skin diseases (VSDs), where lesions are exposed and readily seen, increasing patients' risk of experiencing external stigma from the public and specific professional groups (e.g., service providers). This stigma imposes psychological and social burdens that far exceed the psychological symptoms of the disease. To date, no systematic research has been conducted in China specifically on the external stigma associated with VSDs. Taking psoriasis, vitiligo, and acne as representative conditions, this study aims to explore the external stigma experienced by VSD patients across various social settings and to provide a scientific foundation for the development of measurement tools, quantitative research, and targeted interventions. METHODS: A purposive sample of 23 outpatients diagnosed with psoriasis, acne, or vitiligo was recruited from the Xiangya Hospital Dermatology Clinic of Central South University between December 2023 and July 2024. In-depth qualitative interviews were conducted. Data were analyzed using Mayring's qualitative content analysis and thematic analysis. Reporting followed the Consolidated Criteria for Reporting Qualitative Research guidelines. The interviews focused on the experience of external stigma across different social settings. RESULTS: Patients with VSDs reported experiencing external stigma in various contexts including family, community, recreational service venues, healthcare institutions, and others. The main motivation behind stigmatizing behaviors was disease avoidance (e.g., fear of contagion, aversion, social distancing). Stigmatization in school settings was also reported by patients with all 3 types of VSDs. Psoriasis patients reported stigma across all examined scenarios, while vitiligo and acne patients reported stigma in only some contexts. CONCLUSIONS Patients with VSDs experience significant external stigma, with psoriasis patients facing a higher burden compared to those with vitiligo or acne. The predominant stigma-driving factor is the public's desire to avoid disease, which underscores the need for public education to correct misconceptions about VSDs. External stigma from family, school, social networks, healthcare providers, and structural stigma should be the focus of policy and intervention efforts aimed at protecting the rights and well-being of patients with VSDs.
Humans ; Social Stigma ; Female ; Male ; Qualitative Research ; Acne Vulgaris/psychology* ; Skin Diseases/psychology* ; Adult ; Psoriasis/psychology* ; Vitiligo/psychology* ; Middle Aged ; China ; Young Adult

Objective:To construct a traditional Chinese medicine syndrome differentiation model for tinnitus using automatic machine learning technology, and to explore the key factors that affect the results of tinnitus syndrome differentiation.Methods:The clinical characteristics of 594 patients with subjective tinnitus in seven medical units in Shanghai from January 2021 to January 2022 were retrospectively analyzed. The Auto-sklearn automatic machine learning method was used to compare 15 algorithms, and the model with the best classification effect was selected to analyze the key factors affecting tinnitus.Results:The results showed that the optimal algorithm for classification results was the random forest, its accuracy, precision, sensitivity, specificity, F1-score, AUC and kappa coefficient were 87.37%, 88.34%, 89.06%, 96.63%, 88.38%, 97.50%, and 83.37%, respectively. It is concluded that the key factors affecting the classification of the pattern of kidney yin deficiency and fire effulgence, the pattern of liver fire disturbing upward, the pattern of stagnation and binding of phlegm and fire, the pattern of spleen and stomach deficiency, the pattern of wind and heat attacking the external are smooth pulse, string pulse, smooth pulse, weak tongue, and floating pulse respectively.Conclusions:Random forest can provide a good classification prediction function for structured clinical data, suggesting that machine learning technology has clinical application value in assisting the diagnosis of subjective tinnitus.