doi:10.1016/j.jdin.2025.12.005engBalieva, FloraSchut, ChristinaSzabó, CsanádSampogna, FrancescaDalgard, Florence J.Altunay, Ilknur K.Bewley, AnthonyFerreira, Bárbara RoqueFinlay, Andrew Y.Gieler, UweGracia-Cazaña, TamaraGrivcheva-Panovska, VesnaJemec, Gregor B.Legat, Franz J.Lien, LarsLvov, AndreyMarron, Servando E.Misery, LaurentReich, AdamRomanov, DmitryKoulil, Saskia Spillekom-vanStänder, SonjaSvensson, AkeSzepietowski, Jacek C.Thompson, Andrew R.Titeca, GeraldineTomás-Aragonés, LucíaVulink, NienkeZeidler, ClaudiaKupfer, JörgStress in dermatology patients: A multicenter observational study of 8295 outpatients and controls from 22 European clinicsART-2025-148022Background Skin diseases are symptomatic, visible, and stigmatizing and it is acknowledged that they can be associated with stress. However, large studies comparing disease-specific stress are scarce. Objectives To investigate stress in a large, diverse sample of patients with different skin conditions and identify predictors of stress. Methods A cross-sectional, multicenter study was conducted in 22 dermatology clinics across 17 European countries (response rate 82.4%). The study included 5487 patients diagnosed with various dermatological conditions and 2808 skin-healthy controls. The Perceived Stress Scale, 10 items was used to measure stress. Results Patients reported significantly higher stress levels, more stressful life events during the last 6 months, and more economic difficulties than controls. Patients with psychodermatological conditions, hyperhidrosis, hidradenitis suppurativa, atopic dermatitis, acne, and urticaria experienced the highest stress levels. 44% of the variance of perceived stress in patients with skin conditions could be predicted by sociodemographic data and disease-related and psychological variables (depression, anxiety, stigmatization, and body dysmorphic concerns). Limitations As with all cross-sectional studies, causality and directionality cannot be inferred. Conclusion Stress poses a significant psychosocial burden to dermatological patients, especially to vulnerable subgroups. Health interventions targeting stress may be essential to improve clinical outcomes.2025http://zaguan.unizar.es/record/16857410.1016/j.jdin.2025.12.005http://zaguan.unizar.es/record/168574oai:zaguan.unizar.es:168574JAAD International 25, 69-77 (2025), [9 pp.]byhttps://creativecommons.org/licenses/by/4.0/deed.esinfo:eu-repo/semantics/openAccess