Lei Dongyun, Gong Canyi, Wang Bin, Zhang Litao, Zhang Guoqiang, Man Mao-Qiang
Department of Dermatology, Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China.
Dermatology Hospital of Southern Medical University, Guangzhou, China.
Front Med (Lausanne). 2025 Aug 11;12:1614863. doi: 10.3389/fmed.2025.1614863. eCollection 2025.
Psoriasis is an immune-mediated dermatosis characterized by systemic inflammation and multifactorial pathogenesis. Among its many triggers, psychological stress has emerged as a pivotal yet underappreciated contributor to disease onset and exacerbation. Although the pathomechanisms by which psychological stress is involved in the pathogenesis of psoriasis are not clear, evidence suggests a regulatory role of psychologic stress in immune functions, including increasing expression levels of proinflammatory cytokines and intracellular adhesion molecule-1 (ICAM-1), and decreasing anti-inflammatory cytokines and the function of glucocorticoid receptors, possibly in part via activation of corticotropin-releasing hormone (CRH)-proopiomelanocortin (POMC)-adrenocorticotropic hormone (ACTH)-corticosteroids axis. In addition, the onset and/or worsening of psoriasis can also be attributed to psychological stress-induced defective epidermal permeability barrier function. Moreover, the bidirectional nature of this relationship often leads to a vicious cycle of flare-ups and psychological distress, further complicating patient management and quality of life. This review aims to synthesize current evidence on the relationship between stress and psoriasis, examining mechanistic pathways through which psychosocial stress contributes to immune dysregulation in psoriatic pathology. It also underscores the significance of psychological interventions in the management of psoriasis.
银屑病是一种免疫介导的皮肤病，其特征为全身性炎症和多因素发病机制。在其众多触发因素中，心理压力已成为疾病发作和加重的关键但未得到充分认识的因素。尽管心理压力参与银屑病发病机制的病理机制尚不清楚，但有证据表明心理压力在免疫功能中起调节作用，包括增加促炎细胞因子和细胞间黏附分子-1（ICAM-1）的表达水平，以及降低抗炎细胞因子和糖皮质激素受体的功能，这可能部分是通过激活促肾上腺皮质激素释放激素（CRH）-阿片黑素皮质素原（POMC）-促肾上腺皮质激素（ACTH）-皮质类固醇轴实现的。此外，银屑病的发作和/或加重也可归因于心理压力引起的表皮通透性屏障功能缺陷。而且，这种关系的双向性往往导致病情发作和心理困扰的恶性循环，进一步使患者管理和生活质量复杂化。本综述旨在综合当前关于压力与银屑病关系的证据，研究心理社会压力导致银屑病病理中免疫失调的机制途径。它还强调了心理干预在银屑病管理中的重要性。
