title: Stress and atopic dermatitis.
abstract: Atopic dermatitis (AD) is a complex disease traditionally involving interaction of genetic, environmental, and immunologic factors. Recent studies suggest psycho-neuro-immunologic factors and emotional stress are important in its evolution. The observations that internal (bacterial infections) or external (psycho-logic) stressors may induce AD flares is explained by studies showing that stress impairs the skin barrier function and favors a shift in immunity toward a T helper type 2 cell/allergic response. Furthermore, those with AD appear to have an inherited hypothalamic deficiency that impairs normal hypothalamic-pituitary-adrenal axis function. Neuropeptides released in the skin may also mediate neurogenic inflammation, including mast cell degranulation. AD causes significant stress and impaired quality of life in patients and their family members. Psychologic and stress-reduction interventions were recently shown to improve patient well-being, and to significantly improve cutaneous manifestations.
authors.affiliation: Department of Dermatology, University of Rochester School of Medicine and Dentistry, 601 Elmwood Avenue, Box 697, Rochester NY 14642, USA.
authors.forename: Jenna
authors.initials: J
authors.lastname: Arndt
authors.forename: Nananamibia
authors.initials: N
authors.lastname: Smith
authors.forename: Francisco
authors.initials: F
authors.lastname: Tausk
mesh_terms: D003876:Dermatitis, Atopic / Q000276:immunology / Q000378:metabolism / Q000523:psychology* / Q000628:therapy; D006801:Humans; D009420:Nervous System / Q000276:immunology / Q000378:metabolism; D020078:Neurogenic Inflammation / Q000276:immunology / Q000378:metabolism; D011537:Pruritus / Q000276:immunology / Q000378:metabolism / Q000523:psychology; D011788:Quality of Life; D012867:Skin / Q000276:immunology / Q000378:metabolism; D013315:Stress, Psychological / Q000276:immunology / Q000523:psychology* / Q000628:therapy