Ferreira Bárbara Roque, Aguirre Claudia C, Rapoport-Hubschman Nathalie, Adewuya Abiodun O, Canchy Ludivine, Morizet David, Vincenzi Francesca, McGlone Francis P
Department of Dermatology Centre Hospitalier de Mouscron Hainaut Belgium.
University of Brest Laboratoire interactions épithéliums-neurones (LIEN) Brest France.
Skin Health Dis. 2023 Dec 1;4(1):e310. doi: 10.1002/ski2.310. eCollection 2024 Feb.
Psychodermatology is a subdiscipline of dermatology at the intersection of dermatology, psychiatry, and psychology. In dermatology clinical practice, patients may present with skin disease that affects their mental health, or skin disorders induced or worsened by psychological/psychiatric problems so there is a need for specialised education of dermatologists, as well as multidisciplinary teams, to achieve better management of these patients. Understanding the interaction between the central nervous system and the skin underlying psychocutaneous disorders could help identify alternative therapies that may improve patient well-being. The concept of pleasurable touch has received increasing attention following the discovery of C-tactile (CT) fibres. While afferent C-fibre stimulation is usually associated with pain, temperature, or itch, CT-fibres are stimulated optimally by a stimulus not in the nociceptor range but by a gentle, low-force stroking. As this affective touch may counteract unpleasurable sensations, such as pain and itch, and elicit positive feelings, the potential benefits of gentle touch and massage are interesting for dermatological, especially psychocutaneous, disorders. Here we provide an overview of the skin-brain connection to help understand the benefits of touch and massage, as illustrated with studies on atopic dermatitis and burns, as an adjunct to dermatological treatment for improving patient well-being and optimising treatment outcomes.
心理皮肤病学是皮肤病学的一个子学科,处于皮肤病学、精神病学和心理学的交叉领域。在皮肤科临床实践中,患者可能出现影响其心理健康的皮肤病,或由心理/精神问题诱发或加重的皮肤疾病,因此需要对皮肤科医生以及多学科团队进行专门教育,以便更好地管理这些患者。了解中枢神经系统与心理皮肤疾病背后的皮肤之间的相互作用,有助于确定可能改善患者幸福感的替代疗法。在发现C触觉(CT)纤维后,愉悦触摸的概念受到了越来越多的关注。虽然传入C纤维刺激通常与疼痛、温度或瘙痒有关,但CT纤维在非伤害性感受器范围内的刺激下,通过轻柔、低力度的抚摸能得到最佳刺激。由于这种情感触摸可能抵消诸如疼痛和瘙痒等不愉快的感觉,并引发积极情绪,轻柔触摸和按摩的潜在益处对于皮肤病学,尤其是心理皮肤病学疾病来说很有意义。在此,我们概述皮肤与大脑的联系,以帮助理解触摸和按摩的益处,如通过对特应性皮炎和烧伤的研究所示,作为皮肤科治疗的辅助手段,以改善患者幸福感并优化治疗效果。