Heller M M, Lee E S, Koo J Y
Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
Skin Therapy Lett. 2011 May;16(5):1-4.
Emotional stress may influence the development and exacerbation of psoriasis. The proportion of psoriasis patients who believe stress affects their skin condition (i.e., "stress responders") is considerably high, ranging from 37% to 78%. Stress may worsen psoriasis severity and may even lengthen the time to disease clearance. Although a pathogenic association appears likely, additional well-controlled studies are necessary to confirm such a causal relationship. Dysregulation of the hypothalamus-pituitary-adrenal and sympathetic adrenomedullary systems has been proposed as one possible underlying cause of stress-induced flares of psoriasis. While stress may be an exacerbating factor, psoriasis itself may contribute to significant adverse psychological sequelae. Breaking this stress cycle may be an important part of any therapeutic approach. Thus, stress reduction through psychotherapy and pharmacotherapy may be useful in treating psoriatic patients who are stress responders.
情绪压力可能会影响银屑病的发生和加重。认为压力会影响其皮肤状况的银屑病患者比例（即“压力反应者”）相当高，范围从37%到78%。压力可能会加重银屑病的严重程度，甚至可能延长疾病清除的时间。尽管致病关联似乎很有可能，但仍需要更多严格对照的研究来证实这种因果关系。下丘脑 - 垂体 - 肾上腺和交感肾上腺髓质系统的失调已被提出是压力诱发银屑病发作的一种可能潜在原因。虽然压力可能是一个加重因素，但银屑病本身可能会导致严重的不良心理后果。打破这种压力循环可能是任何治疗方法的重要组成部分。因此，通过心理治疗和药物治疗减轻压力可能对治疗有压力反应的银屑病患者有用。
