Stressful Life Events as Potential Triggers of Pemphigus

Cremniter, D.; Baudin, Marianne; Roujeau, Jean‐Claude; Prost, Cathérine; Consoli, S; Françès, Camille; Chosidow, Olivier

doi:10.1001/archderm.134.11.1486

Cited by 40 publications

(35 citation statements)

References 5 publications

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“…Remarkably, 12 of the 13 patients had experienced a stressful life event during the year preceding the onset of pemphigus. In the majority of cases, the stressor was severe, and in 5 cases it was even traumatic, that is, distressing beyond the range of usual human experience [113]. Despite suggesting a possible role of psychological stress in triggering pemphigus, this study suffers from the lack of a control group and the small sample size.…”

Section: Other Skin Diseasesmentioning

confidence: 99%

Stressful Life Events and Skin Diseases: Disentangling Evidence from Myth

Picardi

Abeni²

2001

Psychother Psychosom

214

144

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The possibility of a causal influence of emotional stress, especially of stressful life events, on the course of various skin diseases has long been postulated. Clinical wisdom and experience, as well as many anecdotal observations and uncontrolled case series, support this opinion. We reviewed the available evidence on the role of stressful life events in triggering or exacerbating skin diseases. The role of stressful events in vitiligo, lichen planus, acne, pemphigus and seborrhoeic dermatitis was either controversial or insufficiently explored. The role of stressful events in psoriasis, alopecia areata, atopic dermatitis and urticaria was apparently clearer. However, only a few studies met acceptable methodological standards for stress measurement. Also, few studies considered common potential confounding factors (e.g. age, duration of illness, familial factors), and no study controlled adequately for the influence of other crucial factors (e.g. discontinuation of treatment, seasonal effects). Adding that the large majority of studies were retrospective, it seems wise to conclude that only preliminary evidence has been published so far on the role of stressful life events in bringing on or worsening any dermatological disease. Further research is mandatory, either in the form of prospective studies or, more feasibly, of well-designed case-control studies with adequate statistical power. Future studies should also pay more attention to protective as well as vulnerability factors in stressful events. Further, it would be important to investigate other sources of psychological stress, such as chronic stress and everyday stress. Measuring stress appraisal, although difficult, would also be important.

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Section: Other Skin Diseasesmentioning

confidence: 99%

Stressful Life Events and Skin Diseases: Disentangling Evidence from Myth

Picardi

Abeni²

2001

Psychother Psychosom

214

144

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“…13 Bu nedenle pemfiguslu gebe sayısı oldukça azdır ve bu konuyla ilgili yeterli araştırma yapılamamıştır. 14 Östrojenin pemfigusun ortaya çıkmasında rol oynadığı öne sürülmüş, ancak gebelikte progesteron hakimiyeti olduğu halde hangi mekanizma ile gebeliğin pemfigusu alevlendirdiği de henüz açıklanamamıştır. İmmün sistem ile sinir sistemi arasındaki etkileşimler daha önce gösteril-miştir.…”

Section: Discussionunclassified

Pemfigusta Risk Faktörleri

Demirci¹,

Mansur²,

Aydıngöz³

2011

TURKDERM

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ÖzetAmaç: Pemfigusun ortaya çıkmasında ve hastalığın seyrinde bazı dış faktörlerin etkili olduğu üzerinde durulmaktadır. Bu araştırma-da pemfigus tanısı ile takip ettiğimiz hastalarda hastalığın etyolojisinde rol oynayabilecek faktörlerin araştırılması amaçlanmıştır. Gereç ve yöntem: Kliniğimizde 1998-2004 yılları arasında histopatolojik ve direkt immunofloresan incelemeler ile pemfigus tanı-sı konan 15'i erkek, 27'si kadın toplam 42 hasta, demografik özellikler, meslek grubu, eğitim düzeyi, hastalığın ortaya çıkmadan önceki süreçte geçirilmiş stresli yaşam olayları, gebelik sayısı, diyet, sigara ve alkol alışkanlığı gibi etkenler açısından sorgulanarak benzer sosyoekonomik düzeye sahip, aynı yaş ve cinsiyetteki bir kontrol grubuyla karşılaştırıldı. Bulgular: Hayvancılık ve tarım ile uğraşmanın, gebelik sayısının fazla oluşunun, sigara içmemenin ve psikolojik stresin pemfiguslu hastalarda kontrol grubuna göre istatistiksel olarak anlamlı oranda yüksek bulunduğu saptandı. Sum maryBackground and Design: There have been reports suggesting the involvement of environmental factors in the disease process of pemphigus. In this study, we aimed to find out the risk factors which could play role in the etiopathogenesis in our pemphigus patients. Material and method: A total of 42 patients (15 male and 27 female) who were diagnosed as pemphigus with histopathological and direct immunoflurosence examinations in our clinic between the years 1998-2004, were interviewed for assessment of regarding with the subjects of the demographic properties, occupational groups, educational level, the number of pregnancies, stressfull life events, diet habits, smoking and alcohol consumption before the onset of the disease and the results were compared to 42 age and gender-matched controls with similar socioeconomic circumstances. Results: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were found to be statistically significant in pemphigus patients than in controls. Conclusion: Working in agriculture and livestock, multi-parity, absence of smoking and stressfull life events were assumed to play role in the etiopathogenesis and course of pemphigus. (Turk derm 2011; 45: 140-5)

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“…Pemphigus is no exception to this. In fact, cases of pemphigus triggered by emotional stress are not exceedingly rare [74, 75, 76, 77, 78]. Furthermore, in most patients with idiopathic pemphigus the possible existence of a psychological precipitating factor is overlooked or ignored by both the patient and the physician.…”

Section: Emotional Stressmentioning

confidence: 99%

“…Furthermore, in most patients with idiopathic pemphigus the possible existence of a psychological precipitating factor is overlooked or ignored by both the patient and the physician. Yet, a recent clinical investigation on 13 consecutive pemphigus patients revealed that 12 of them had experienced a stressful life event during the year preceding the onset of the autoimmune disease [78]. …”

Section: Emotional Stressmentioning

confidence: 99%

Precautions and Suggestions for Pemphigus Patients

2001

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The onset and course of pemphigus are often the result of an interaction between predisposing genetic factors and environmental triggering agents. The latter are heterogeneous, numerous and increasing, ranging from drug intake (the commonest cause of pemphigus induction) to the exposure to physical agents (heat, UV and ionizing rays, surgical and cosmetic procedures), viral infections (especially by herpesvirus), contact dermatitis, certain diet ingredients and even emotional stress. Alerting physicians and pemphigus patients to the effects that unsuspected precipitating factors may have on the progression of the disease is an important task. In fact, avoiding or limiting deleterious habits (e.g. overindulging in unnecessary drugs) and suggesting alternative ways (e.g. substituting potentially pemphigus-inducing drugs with others considered harmless in this respect) may be a useful precaution in the management of pemphigus patients, since it can improve the efficacy of conventional treatments, reduce the risks of relapses and sometimes result in a cure.

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Stressful Life Events as Potential Triggers of Pemphigus

Cited by 40 publications

References 5 publications

Stressful Life Events and Skin Diseases: Disentangling Evidence from Myth

Stressful Life Events and Skin Diseases: Disentangling Evidence from Myth

Pemfigusta Risk Faktörleri

Precautions and Suggestions for Pemphigus Patients

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