Supplementary Material for: Highlighting Migration in Dermatology: Population characteristics among patients seen in a dermatological out-patient clinic in Southern Sweden

Abstract

Introduction
Migration is an increasing phenomenon and associated with a physical and psychosocial burden on individuals. Little is known about migration and skin health. The objective of this study is to describe the characteristics of patients regarding migration background and dermatological morbidity among adults seen in a dermatological out-patient clinic in Malmo, Sweden.

Methods
An observational cross-sectional study was performed in 2017. Dermatological outpatients completed questionnaires and were examined by a dermatologist. Sociodemographic variables including ethnicity and migration status were assessed by self-report. Ethnicity was assessed with country of birth. General and physical health and details about skin disease were self-reported. Stress was assessed by the Perceived Stress Scale (PSS) and with items assessing stressful life events and economic difficulties. Depression and anxiety were assessed with The Patient Health Questionnaire-2 (PHQ-2) and The General Anxiety Disorder Assessment-2 (GAD-2).

Results
250 patients were included. 24% were foreign born (FB) reporting 41 different countries of birth. Mean duration of living in Sweden was 24.4 years. Compared to non-foreign born (NFB) patients, FB patients were more stressed (PSS mean 17.5 vs 15.3, p = 0.044), had more economic difficulties (31.0% vs 14.6%, p = 0.005) and more anxiety (39.7% vs 24.9%, p = 0.03). There were significantly fewer patients with psoriasis in FB and more with connective tissue disease. FB rated skin disease severity significantly higher than NFB patients

Conclusion
This study reports the multi-ethnic population in an out-patient dermatological clinic in Malmo, Sweden and the difference in distribution of dermatological conditions among FB patients and NFB patients as well as the burden of disease, with higher levels of stress and anxiety in FB patients. These issues will be investigated further by our group in a larger multicentre study.