Stressed skin? – a molecular psychosomatic update on stress‐causes and effects in dermatologic diseases

Abstract

SummaryA pathogenetically relevant link between stress, in terms of psychosocial stress, and disease was first described in the 1970s, when it was proven that viral diseases of mucous membranes (such as rhinovirus and Coxsackie virus infections) develop faster and more severe after stress exposure. Since then, there has been an annual increase in the number of publications which investigate this relationship and break it down to the molecular level. Nevertheless, the evidences for the impact of psychosocial stress on chronic inflammatory skin diseases and skin tumors are hardly known. In the present review, we outline current insights into epidemiology, psychoneuroimmunology, and molecular psychosomatics which demonstrate the manifold disease-relevant interactions between the endocrine, nervous, and immune systems. The focus is on stress-induced shifts in immune balance in exemplary disorders such as atopic dermatitis, psoriasis, and malignant melanoma. The objective of this article is to convey basic psychosomatic knowledge with respect to etiology, symptomatology, and therapeutic options for chronic skin diseases. Particular attention is directed towards the underlying molecular relationships, both from a somatic to mental as well as a mental to somatic perspective.

Comparison of Personality Traits among Patients with Psoriasis, Atopic Dermatitis, and Stress: A Pilot Study

“…Stress is reported to be an important trigger and exacerbating factor for psoriasis (Pso) and atopic dermatitis (AD) [1], rendering both chronic skin diseases psychophysiological disorders. Presumably, Pso and AD patients experience and cope with stress differently than healthy people [2] and may benefit from psychological intervention to help with reinterpreting events and develop new coping strategies to stressful events [3].…”

Opioid Receptors in Psoriatic Skin: Relationship with Itch

“…Skin lesions in patients with psoriasis are often accompanied by itch; approximately 70-90% of patients with psoriasis have this unpleasant sensation (4). The molecular basis for psoriatic itch is unknown; however, the disordered interplay between skin, immune cells, genetic and neurological systems with decreased psychoneurophysiological tolerance is considered to be the main factor potentiating itch transmission (4)(5)(6)(7). Recent data suggest that the endogenous opioid system (EOS) and peripheral innervations of axonal nerve terminals of neurones from dorsal root ganglions (DRG) may participate in itch transmission (8).…”

Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire

“…In both studies, patients were recruited from dermatology reference centers, which may reflect a better experience in their disease management. All in all, items have been shown to be discriminant, with average values that may vary between 2.50 and 4.49, most of them covering the full range of options (1)(2)(3)(4)(5).…”

“…In addition to correct administration of treatment, it is important to deal with emotions, attend scheduled visits and modify the style of interaction between healthcare Development and validation of a questionnaire to measure empowerment in adult patients with atopic dermatitis. The DATEMP questionnaire professionals and patients in order to improve clinical disease control [3][4][5]. In chronic diseases, only 2 % of care is carried out by healthcare professionals, hence the importance of the patient knowing how to manage the remaining 98 % [6].…”