New Scale Developed to Assess Anxiety-Related Checking and Avoidance in Pemphigus Patients

Researchers have developed a new questionnaire to assess anxiety-related checking and avoidance behaviours among people living with pemphigus vulgaris, a chronic autoimmune condition that causes painful blisters and erosions on the skin and mucous membranes.

The new instrument, called the Skin Checking and Avoidance Behaviors Scale (SCABS), was developed by researchers from Yale School of Public Health, Yale School of Medicine and collaborating institutions. The scale is intended to capture behaviours that may arise when patients become increasingly worried about a possible recurrence of their disease.

People with pemphigus may repeatedly inspect their skin or mouth for signs of new lesions. Some may also avoid physical contact, particular foods or activities because they fear these could trigger or worsen their condition. Until now, there had been no disease-specific tool designed to measure these behaviours in patients with pemphigus.

To develop the questionnaire, researchers obtained input from people living with the condition as well as healthcare professionals who treat pemphigus. The resulting scale was then assessed using responses from 160 participants.

Statistical analysis identified three main areas within the questionnaire: checking and worrying, contact avoidance, and ingested or situational avoidance. The researchers found that the different sections showed strong internal consistency, indicating that the questions within each area were measuring related behaviours.

Higher scores were also associated with factors including anxiety, depression, fear of disease recurrence, remission status and difficulties affecting occupational activities. These findings suggest that checking and avoidance behaviours may occur alongside other psychological and functional difficulties experienced by people with pemphigus.

The researchers described the instrument as a preliminary validation and noted that additional studies are required to examine its performance in other patient populations and clinical settings.

25-09-2026