How stress gets under the skin: cortisol and stress reactivity in psoriasis

Evers, Andrea W. M.; Verhoeven, E.W.M.; Kraaimaat, Floris W.; Jong, E.M.G.J. de; Brouwer, S.J.M. de; Schalkwijk, Joost; Sweep, Fred C.G.J.; Kerkhof, P.C.M. van de

doi:10.1111/j.1365-2133.2010.09984.x

Cited by 117 publications

(113 citation statements)

References 33 publications

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“…Evers et al, found psoriasis patients had significantly lower cortisol levels at moments when daily stressors are at peak levels. The study also reported that psoriasis patients with overall high levels of daily stressors exhibited lower mean cortisol levels, as compared to psoriatics with overall low levels of daily stressors (Evers et al, 2010) (Zangeneh et al, 2008). These blunted HPA axis and elevated SAM system responses to stress may be crucial in better understanding the inflammatory characteristics of psoriasis, particularly in stress-responders.…”

Section: Psoriasis and Stressmentioning

confidence: 98%

“…These blunted HPA axis and elevated SAM system responses to stress may be crucial in better understanding the inflammatory characteristics of psoriasis, particularly in stress-responders. For instance, decreased secretion of cortisol and increased levels of epinephrine (Zangeneh et al, 2008) and norepinephrine may stimulate the release of mast cells, affect skin barrier function, and upregulate proinflammatory cytokines, which could thereby maintain or exacerbate psoriasis severity (Evers et al, 2010). Some authors have commented that this decreased cortisol response may be similar to how psoriasis flares with steroid withdrawal, as evidenced by the well known phenomena of steroid-induced psoriasis rebound (Richards et al, 2005).…”

Section: Psoriasis and Stressmentioning

confidence: 99%

See 1 more Smart Citation

Psoriasis and Stress – Psoriasis Aspect of Psychoneuroendocrinology

Zangeneh¹,

Fazeli²,

Shooshtary³

2012

Psoriasis

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Section: Psoriasis and Stressmentioning

confidence: 98%

Section: Psoriasis and Stressmentioning

confidence: 99%

Psoriasis and Stress – Psoriasis Aspect of Psychoneuroendocrinology

Zangeneh¹,

Fazeli²,

Shooshtary³

2012

Psoriasis

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“…The relationship between stress and the course of a condition could in part be explained by the role that the immune system plays in chronic inflammatory skin diseases. More specifically, neuroendocrine and immune mechanisms (for example cortisol and cytokines) can be influenced by stress and can in turn influence chronic skin-related inflammatory activity [22,24]. Indeed, several prospective studies found a link between stressors and the course of conditions [23 -25].…”

Section: Psychosocial Factors In Dermatological Conditionsmentioning

confidence: 99%

“…Accordingly, in patients with atopic eczema, subjective stress proved to predict disease severity on the following day [26]. Additionally, in patients with psoriasis, high levels of daily stressors were associated with an increase in disease severity and itch four weeks later [24,25]. Stressors can influence wound healing [27], although this relationship has not been studied in patients with skin conditions.…”

Section: Psychosocial Factors In Dermatological Conditionsmentioning

confidence: 99%

Psychological Treatments for Dermatological Conditions

2016

Skin and Psyche

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Abstract:The impact of dermatological conditions on a patient's life is frequently underestimated. Patients with skin conditions experience several physical complaints, including itch, pain and fatigue. Furthermore, in comparison to the general population, patients report a decreased psychological well-being, lowered quality of life and feelings of stigmatization and shame. Psychological treatments are widely used in addition to regular dermatological treatments to improve physical and psychological functioning of patients with chronic skin conditions. These treatments are usually aimed at changing the psychosocial factors that can influence the onset and/or course of skin conditions, such as dysfunctional coping behaviors, itch-scratching problems and stress. There are unimodal interventions in which single treatments are used, for example psychoeducation or relaxation exercises, and multimodal treatments in which a variety of different interventions are applied based on cognitive-behavioral therapy and self-management principles. Furthermore, a distinction can be made between interventions that focus primarily on skin-related psychosocial problems, interventions that focus on itch-scratching problems, and interventions that are focused on psychiatric problems in the dermatological practice. This chapter gives an overview on the psychosocial factors relevant for dermatological conditions, relevant diagnostic methods and the content and scientific evidence of specific psychological treatments in these different categories.

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“…az egyéb pszichoszomatikus hátterű (például krónikus fejfájás, essentialis hypertensio, irritábilis bél szindróma, rheumatoid arthritis, asztma, fi bromyalgia) betegségek-hez hasonlóan, a pikkelysömörös betegekben is az átlag-populációnál magasabb (8-10% vs. 15-51%) [12,14,15,16,17,18,19,20,21,22,23,24]. Taylor szerint az érzelmek szerepe többek között a megfelelő stresszpercepció kialakítása és ezáltal a viselkedésnek a sikeres alkalmazkodás érdekében a környezeti igényekhez történő alakítása [25].…”

Section: Conrad éS Mtsai [24]unclassified

Psychological and biological background of the interaction between psoriasis and stress

et al. 2014

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A pikkelysömör kialakulásában és progressziójában a betegek és az orvosok jelentős hányada a stresszt tartja az egyik legfontosabb rizikótényezőnek. Mivel a stresszor és hatásai is egyaránt szubjektumfüggőek és így nehezen mérhe-tőek, sokáig csupán kevés, a stressznek a betegség kialakulásában játszott szerepét vizsgáló tanulmány készült. Az elmúlt években azonban egyre több nívós, objektív mérésekkel alátámasztott vizsgálat született, amelyek új, érté-kes adatokkal szolgáltak a háttérben zajló patofi ziológiai folyamatok megértéséhez. A szerzők a szakirodalomban fellelhető stresszexpozíciót és -percepciót befolyásoló pszichológiai (alexithymia, személyiség, hangulat) és a stresszválaszt szabályozó biológiai (kortizol-, adrenalinszintek, neurogén gyulladás) tényezőket elemző vizsgálatokat integratív, pszichoszomatikus szemlélettel tekintik át, és bemutatják, hogy az eddig főleg csak tapasztalati szinten bizonyí-tott kapcsolatot egyre több modern, magas színvonalú kutatási eredmény igazolja. Ismerve a stresszcsökkentő pszichofarmakológiai és pszichoterápiás intervenciók sikerességét a pikkelysömör kezelésében és a betegek életminő-ségének javításában, a szerzők bíznak abban, hogy tanulmányuk hozzájárul a pszichoszomatikus szemlélet szélesebb körű elterjedéséhez a mindennapi bőrgyógyászati gyakorlatban. Orv. Hetil., 2014, 155(24), 939-948. Kulcsszavak: pikkelysömör, stressz, személyiség, kortizol, neurogén gyulladás Psychological and biological background of the interaction between psoriasis and stressStress is considered as a major contributor to the development and exacerbation of psoriasis by a signifi cant proportion of patients and dermatologists. As both stressor and its effects are subject-dependent, thus extremely diffi cult to measure, our understanding of the exact role of stress in disease development was limited for a long time. In the past decade several new studies were carried out which expanded our knowledge on the pathophysiologic processes linking stress to psoriasis via with their objective measurements and the applied new techniques. The authors review the current literature of both psychological (alexithymia, personality, affect) and biological (cortisol, epinephrine, neurogenic infl ammation) factors infl uencing stress perception and response in psoriasis. Results of recent investigations support previous reports about the interaction between stress and psoriasis with objective evidence. Knowing how effective stress-reducing psychopharmacologic and psychotherapeutic interventions are in the treatment of psoriasis the authors hope that this review contributes to a wider acceptance of the psychosomatic attitude in everyday dermatologic practice.

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How stress gets under the skin: cortisol and stress reactivity in psoriasis

Cited by 117 publications

References 33 publications

Psoriasis and Stress – Psoriasis Aspect of Psychoneuroendocrinology

Psoriasis and Stress – Psoriasis Aspect of Psychoneuroendocrinology

Psychological Treatments for Dermatological Conditions

Psychological and biological background of the interaction between psoriasis and stress

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