ABSTRACT
Atopic dermatitis is a relapsing, chronic, inflammatory skin disorder that incurs significant morbidity and socioeconomical costs to patients and their families. The cause of atopic dermatitis (AD) is currently under investigation. The pathogenesis of AD is believed to be multifactorial, including genetic factors, immunological derangements, and allergenic environmental triggers (1). Increased psychological stress has clearly been shown to exacerbate or initiate the onset in a large proportion of AD patients (2-4). Psychological stress is clearly not an antigen, yet the majority of investigation about the pathogenesis of AD is focused on immunological and antigenic pathways, largely ignoring the role of the psyche and the nervous system. Although physicians have long recognized the role of psychological stress in the clinical exacerbation of AD, only a few studies
have examined the psychoneuroimmunological pathogenesis of AD as a contributing etiological or exacerbating factor in AD. This chapter reviews recent studies that have investigated the neuroimmunological pathogenesis of psychological stress on AD and attempt to integrate this with current physiological explanations regarding the pathogenesis of AD.
