Department of Dermatology, Faculty of Medicine, Shimane University, Izumo, Japan.
J Dermatol. 2018 May;45(5):554-559. doi: 10.1111/1346-8138.14277. Epub 2018 Mar 3.
Stress-induced scratching is an issue in patients with adult atopic dermatitis (AD). Symptoms of stress-induced AD are common in clinical practise. Salivary chromogranin A (CgA) level has research value as a possible index related to a patient's psychological stress. Using saliva, which is easily collectable, we compared two assessments of the severities of AD and stress with the levels of stress proteins in the saliva of 30 patients with AD in the Department of Dermatology of Shimane University between April 2015 and May 2017. The severities of AD and stress were assessed using the Scoring Atopic Dermatitis (SCORAD) score and State-Trait Anxiety Inventory score, respectively. Additionally, the assessments included those of personality using the Tokyo University Egogram (TEG)-II score and quality of life using the Dermatology Life Quality Index score. Simultaneously, we measured their salivary CgA levels. The change in salivary CgA per protein in patients with AD was correlated with their changes in SCORAD score (correlation coefficient, r = 0.596, P = 0.001) and objective SCORAD (r = 0.608, P < 0.001). The changes in CgA per protein correlated with those in TEG-II A (r = 0.370, P = 0.022), while the changes in SCORAD score correlated with those in DLQI (r = 0.309, P = 0.048). Our results suggest that changes in a patient's condition are reflective of the changes in the patient's stress. The changes in salivary CgA level in patients with AD correlated with the changes in their condition.
压力诱导性搔抓是成人特应性皮炎（AD）患者的一个问题。在临床实践中，压力诱导性 AD 的症状很常见。唾液嗜铬粒蛋白 A（CgA）水平作为与患者心理压力相关的可能指标具有研究价值。我们使用容易采集的唾液，于 2015 年 4 月至 2017 年 5 月在岛根大学皮肤科对 30 例 AD 患者进行了两项 AD 和压力严重程度评估，并比较了唾液中应激蛋白的水平。使用 SCORAD 评分和状态-特质焦虑量表（STAI）评分分别评估 AD 和压力的严重程度。此外，还使用东京大学 Egogram（TEG）-II 评分评估人格，使用皮肤病生活质量指数（DLQI）评分评估生活质量。同时，我们测量了他们的唾液 CgA 水平。AD 患者唾液 CgA 每蛋白的变化与他们的 SCORAD 评分变化（相关系数 r = 0.596，P = 0.001）和客观 SCORAD（r = 0.608，P < 0.001）变化相关。CgA 每蛋白的变化与 TEG-II A 相关（r = 0.370，P = 0.022），而 SCORAD 评分的变化与 DLQI 相关（r = 0.309，P = 0.048）。我们的结果表明，患者病情的变化反映了患者压力的变化。AD 患者唾液 CgA 水平的变化与病情变化相关。
