Berg M, Svensson M, Brandberg M, Nordlind K
Department of Dermatology, University Hospital, Uppsala, Sweden.
J Eur Acad Dermatol Venereol. 2008 Jun;22(6):670-4. doi: 10.1111/j.1468-3083.2008.02642.x. Epub 2008 Mar 18.
Psoriasis is generally thought to be worsened by stress. This presumption has been supported primarily by retrospective studies using questionnaires. No controlled prospective study on this issue has been performed.
Nine women with moderate plaque psoriasis were enrolled in the study. They all believed that their psoriasis was worsened by stress. They filled in a daily diary with estimations of actual stress levels and grades of psoriasis. The study of each patient started when her skin disease was in a stable phase and was concluded when her psoriasis was worsened by at least 25% from the starting level. Psoriasis area severity index scores were recorded at the start, as soon as possible after exacerbation and 2 weeks later. Stress-related blood samples were taken at the same visits. The study was analysed as a nine-case study.
No clear pattern was found between stress levels and worsening of psoriasis in our nine patients. One patient had elevated stress levels 13 days before exacerbation of psoriasis, but for at least seven patients, there were no identifiable time relationships between stress and psoriasis appearance. For two patients, there were clear elevations of stress levels after psoriasis outbreak.
This limited study does not support the assumption that stress is a worsening factor in psoriasis.
银屑病通常被认为会因压力而加重。这一推测主要得到了使用问卷的回顾性研究的支持。尚未有关于此问题的对照前瞻性研究。
9名中度斑块状银屑病女性患者参与了该研究。她们都认为自己的银屑病会因压力而加重。她们填写每日日记，记录实际压力水平和银屑病严重程度分级。每位患者的研究在其皮肤病处于稳定期时开始，在其银屑病比起始水平恶化至少25%时结束。在开始时、病情加重后尽快以及2周后记录银屑病面积严重程度指数评分。在相同就诊时采集与压力相关的血样。该研究作为一项9例患者的研究进行分析。
在我们的9名患者中，未发现压力水平与银屑病加重之间有明确的模式。1例患者在银屑病加重前13天压力水平升高，但至少7例患者中，压力与银屑病出现之间不存在可识别的时间关系。对于2例患者，在银屑病发作后压力水平明显升高。
这项有限的研究不支持压力是银屑病加重因素这一假设。
