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Psychological Stress in Atopic Dermatitis

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Evolution of Atopic Dermatitis in the 21st Century


Accurately evaluating the factors that exacerbate atopic dermatitis is helpful in management of this skin condition. Psychological stress is a major exacerbating factor and often aggravates atopic dermatitis. The most common symptoms of atopic dermatitis themselves can also act as secondary stressors and lead to a deterioration in quality of life. Moreover, patients with atopic dermatitis may also suffer from other mental disorders such as depression and anxiety. It is known that psychological stress is associated with abnormal skin barrier function and a shift toward cytokine expression in T-helper 2 cells. The stress response affects three systems: the hypothalamic-pituitary-adrenal axis, which regulates the release of adenocorticotropin and cortisol; the sympathoadrenal medullary axis, which regulates the release of catecholamines; and the neurotrophin neuropeptide axis, which regulates the release of substance P. Therefore, treatment for psychological stress is quite important for controlling skin barrier function and inhibiting immune activation in cases of atopic dermatitis. Treatments for psychological stress include pharmacotherapy, such as topical corticosteroids, and psychotherapy, such as relaxation exercises, coping skills training, and stress management instruction.

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Correspondence to Mayuko Nakano-Tahara M.D., Ph.D. .

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Nakano-Tahara, M., Murota, H., Katayama, I. (2018). Psychological Stress in Atopic Dermatitis. In: Katayama, I., Murota, H., Satoh, T. (eds) Evolution of Atopic Dermatitis in the 21st Century. Springer, Singapore.

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