Arnetz B B, Fjellner B, Eneroth P, Kallner A
Department for Stress Research, Karolinska Institute, Stockholm, Sweden.
Acta Derm Venereol Suppl (Stockh). 1991;156:9-12.
The role of psychosocial stress in the etiology and clinical course of psoriasis and atopic dermatitis still remains to be elucidated. In this study, we assessed neuroendocrine, dermatological, and cognitive responses in healthy subjects and in subjects suffering from psoriasis and atopic dermatitis, respectively. Perceived stress increased the most in psoriatics during the stressor exposure but tended to return faster to baseline in this group than was found for atopics and healthy controls. Growth hormone secretion was attenuated during stress in patients with skin disorders. Overall, neuroendocrine reactivity was similar in the three groups. Dermal flare reactivity was enhanced in healthy controls but perceived itch enhanced in atopics in response to stress. Stress per se was not an important discriminator between groups. Coping style and other cognitive factors turned out to be of significant importance to predict skin reactivity rather than a specific skin disease. The study suggests that psychosocial stress affects the skin reactivity and that cognitive factors modulate such effects. However, a specific skin condition explains only a fraction of the overall variance in skin reactivity to specific stressors.
心理社会应激在银屑病和特应性皮炎的病因及临床病程中的作用仍有待阐明。在本研究中,我们分别评估了健康受试者以及患有银屑病和特应性皮炎的受试者的神经内分泌、皮肤和认知反应。在应激源暴露期间,银屑病患者感知到的应激增加最多,但与特应性皮炎患者和健康对照组相比,该组应激水平倾向于更快恢复到基线。皮肤疾病患者在应激期间生长激素分泌减弱。总体而言,三组的神经内分泌反应性相似。健康对照组的皮肤潮红反应性增强,但特应性皮炎患者对应激的感知瘙痒增强。应激本身并非区分各组的重要因素。应对方式和其他认知因素对于预测皮肤反应性而非特定皮肤病具有重要意义。该研究表明,心理社会应激会影响皮肤反应性,且认知因素会调节这种影响。然而特定的皮肤状况仅解释了皮肤对特定应激源反应性总体差异的一小部分。