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  • Essay / Psychological Stress and Skin Diseases

    Many mental health disorders and conditions, such as obsessive-compulsive disorder, anxiety, stress, and other psychological problems, can cause skin diseases because the nature of the skin is an easily accessible target for patients with such a sensitive situation. It is also clear that, conversely, skin diseases can cause psychosocial distress due to their adverse aesthetic and/or symptomatic effects. What remains obscure is the etiological role of psychological stress in the onset and aggravation of skin diseases. The likelihood of a causal impact of emotional stress, primarily stressful life events, on the course of various skin diseases has long been postulated. Clinical knowledge and experience, as well as a number of observations and uncontrolled case series, support this assertion. In this essay, I will review the available evidence on the role of stressful life events in triggering or exacerbating skin diseases. The role of stressful life events in vitiligo, lichen planus, acne, pemphigus, and seborrheic dermatitis was either poorly explored or controversial. The role of stressful life events in psoriasis, alopecia areata, atopic dermatitis and urticaria was obviously clearer. A few studies have considered common potential confounders (e.g. age, disease duration, genetic factors), and almost no studies have adequately considered the influence of other factors critical (e.g. stopping treatment, smoking, seasonal effects). So far, it can be stated that only preliminary evidence has been published on the role of stressful life events in triggering or worsening dermatological disease. Say no to plagiarism. Get a tailor-made essay on “Why violent video games should not be banned”? Get an original essay The skin plays a vital role as a tactile organ in socialization processes from early childhood and throughout the life cycle life, having central significance as an organ of communication, being affected by an assortment of emotional stimuli, and significantly influencing a person's self-perception and confidence. It is very important to mention that the skin and the central nervous system are embryologically linked, since both the epidermis and the neural plate derive from the embryonic ectoderm1. It is therefore not surprising that the presence of a link between mental state and dermatological disease has long been seen and represented. Some possible links between mental state or mental disorders and skin diseases have been proposed. To begin with, patients with a diagnosed psychological illness may attract the attention of the dermatologist due to hypochondria, self-harm, or skin delusions. Second, systemic diseases, such as systemic lupus erythematosus or porphyria, can manifest as both skin diseases and mental side effects. Third, medications used to treat dermatological conditions (e.g. corticosteroids, antihistamines) can trigger mental aggravations and, again, psychotropic medications, e.g. lithium or some antipsychotics, can act on the skin. Fourth, psychological side effects may appear. in patients with primary skin diseases in response to a reaction to disfigurement or perceived social stigma2. In this essay I will review the available evidence on the role ofstressful life events in relation to the onset or exacerbation of skin diseases. I will try to answer the following question: what, if any, is the relationship between psychological state and skin diseases? Although the association seems almost clear and is often taken for granted, it is very difficult to explain the relationship between these two broad entities, since research data is routinely reviewed or subjected to meta-analyses. This complex and chronic skin disease has received the most attention from a psychological perspective. For over a century, there have been many hypotheses writing about the connection between psychological stress and psoriasis, and the trend continues to this day. It turns out that psychological stress is cited as a causal factor in psoriasis, both by dermatologists and patients. From a sample of 62 French dermatologists who responded to a short questionnaire, 100% agreed that stress has an essential impact on psoriasis3. Likewise, the number of patients who believe that psychological stress is an independent causal factor or acts as an element of intensification of psoriasis is very high, the studies reporting oscillate between 37 and 78%4. Numerous uncontrolled investigations support the thesis that emotional stress, most often in the form of stressful life events, plays an important role in triggering or exacerbating psoriasis in a high percentage of cases. Susskind and McGuire found that 40% of 20 hospitalized patients mentioned anxiety and unexpressed resentment induced by upsetting life events before illness onset; with relapses, this percentage increased to 70%5. De la Brassinne and Nays also examined the clinical records of more than 200 patients and reported that a significant psychological event was a precipitating factor in 40% of new cases and in 80% of relapses6. In summary, a larger portion of the studies reviewed implicate the role of stressful life events in triggering, exacerbating, or worsening psoriasis. However, there still does not appear to be conclusive evidence because widely accepted methodological standards for life events research have only been met by a small number of studies and no studies have considered the The influence of possible confounding factors such as stopping medical treatment, alcohol consumption, smoking, exposure to the sun or seasonal effects, as previously indicated. It can be concluded that preliminary evidence has been gathered so far and further research is needed. Atopic dermatitis (AD) is a chronic inflammatory skin disease associated with skin hyperreactivity to environmental triggers and is often the first step in the atopic march leading to asthma and allergic rhinitis [1]. Clinically, AD is characterized by pruritic, eczematous, ill-defined, and erythematous plaques with a predilection for skin flexures. Typically, AD manifests during infancy and early childhood; 85% of affected children present symptoms before the age of 5 [2]. With an estimated prevalence of 17% among American schoolchildren, AD is the most common chronic childhood disease; its prevalence seems to be increasing [3]. The cause of AD is poorly understood, but is thought to involve a complex interplay of genetic predisposition, environment, altered immunological function, and psychological influences. New insights into its etiology include mutations in filaggrin and Toll-like receptor 2 (TLR2). Filaggrin is involved in the envelope.