Association of stress with symptoms of atopic dermatitis.
Psychological stress and atopic dermatitis (AD) symptoms appear to form a vicious cycle. This study compared the degree of stress and impairment of dermatology life quality between patients with AD and healthy controls, and examined for neuropeptides and neurotrophins associated with stress in AD. Questionnaires, comprising five tests evaluating depression, anxiety, interaction anxiousness, private body consciousness, and dermatology life quality, were examined in age- and sex-matched patients with AD (n = 28) and healthy controls (n = 28). Immunohistochemical staining of nerve growth factor, substance P, corticotrophin-releasing factor receptor and neuropeptide Y was performed in the AD-involved and normal skin. Patients with AD showed high scores on all of the questionnaires, including Beck Depression Inventory, state anxiety, trait anxiety, Interaction Anxiousness Scale, Private Body Consciousness subscale, and Dermatology Life Quality Index. All of the parameters, except for Beck Depression Inventory, showed higher values in AD than healthy controls (p < 0.001). Statistically significant correlations were observed between each psychological parameter and Dermatology Life Quality Index. Among the clinical parameters, only pruritus was positively correlated with state anxiety (R = 0.573, p < 0.05) and trait anxiety (R = 0.525, p < 0.05). The Eczema Area and Severity Index score did not show any significant correlations with psychological parameters. Nerve growth factor-reactive cells were observed more abundantly and intensely in both epidermis and dermis of AD involved skin (n = 4) than in healthy controls (n = 3) (p = 0.022 and 0.029, respectively). Also, the number and intensity of neuropeptide Y-positive cells was significantly greater in the entire epidermis of patients with AD than in healthy controls (n = 3) (p = 0.029 and 0.026, respectively). We conclude that anxiety may be associated with the induction of pruritus through neuro-peptide Y and nerve growth factor.
Department of Dermatology, Cutaneous Biology Research Institute, Yonsei University College of Medicine, Seodaemoon-gu, Seoul, Korea.
Sang Ho
SH
Oh
Byung Gi
BG
Bae
Chang Ook
CO
Park
Ji Yeon
JY
Noh
Il Ho
IH
Park
Wen Hao
WH
Wu
Kwang Hoon
KH
Lee
D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D001706:Biopsy; D016022:Case-Control Studies; D002648:Child; D003863:Depression / Q000150:complications; D003876:Dermatitis, Atopic / Q000175:diagnosis / Q000378:metabolism / Q000523:psychology*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D020932:Nerve Growth Factor / Q000032:analysis; D009478:Neuropeptide Y / Q000032:analysis; D011379:Prognosis; D011537:Pruritus / Q000378:metabolism / Q000523:psychology; D011788:Quality of Life; D018019:Receptors, Corticotropin-Releasing Hormone / Q000032:analysis; D056910:Republic of Korea; D012720:Severity of Illness Index; D012867:Skin / Q000737:chemistry*; D013315:Stress, Psychological / Q000150:complications* / Q000175:diagnosis / Q000378:metabolism; D013373:Substance P / Q000032:analysis; D011795:Surveys and Questionnaires; D055815:Young Adult
D009478:Neuropeptide Y; D018019:Receptors, Corticotropin-Releasing Hormone; D013373:Substance P; D020932:Nerve Growth Factor