ABSTRACT
The role of stress in its various forms has been investigated in relation to a great number of cutaneous diseases (1). Such diseases as psoriasis, atopic dermatitis, urticaria, seborrheic dermatitis, alopecia areata, telogen effluvium, herpesvirus infection, pemphigus, acne vulgaris, lichen planus, vitiligo, aphthae, and acne rosacea have been reported to be associated with stress-induced exacerbations. Unfortunately, much of the data suggesting this postulated association is derived from anecdotal evidence, case series, and unconventional investigations. Picardi and Abeni (2) reviewed much of the extant literature on stressful life events and their role in skin disease with an emphasis on examining the scientific rigor of the available evidence. Though they found that many of the studies’ methods for stress measurement did not meet rigorous standards, the role of stress in exacerbating psoriasis, atopic dermatitis, urticaria, and alopecia areata appeared clear. On the other hand, the contribution of stressful events to the
worsening of vitiligo, lichen planus, acne, pemphigus, and seborrheic dermatitis remained less clear. This chapter will describe some of the fundamental physiological events of the stress response and elucidate a few mechanisms by which the stress response may potentially exacerbate such cutaneous diseases as psoriasis, recurrent herpes infection, and atopic dermatitis.
