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Skin disorders

from Medical topics

Published online by Cambridge University Press:  18 December 2014

By
Ulrich Stangier
Edited by
Susan Ayers ,
Andrew Baum ,
Chris McManus ,
Stanton Newman ,
Kenneth Wallston ,
John Weinman  and
Robert West
Ulrich Stangier
Affiliation:
Friedrich-Schiller-Universität Jena
Susan Ayers
Affiliation:
University of Sussex
Andrew Baum
Affiliation:
University of Pittsburgh
Chris McManus
Affiliation:
St Mary's Hospital Medical School
Stanton Newman
Affiliation:
University College and Middlesex School of Medicine
Kenneth Wallston
Affiliation:
Vanderbilt University School of Nursing
John Weinman
Affiliation:
United Medical and Dental Schools of Guy's and St Thomas's
Robert West
Affiliation:
St George's Hospital Medical School, University of London
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Summary

Overview of the general area

There is a long tradition of the view that emotional stress might act as a precipitating factor in the onset or exacerbation of skin disorders. The close relationship of the skin with psychological functions is reflected in a variety of expressions such as ‘to be red with rage’ or ‘to jump out of one's skin’. In addition, psychoimmunological and psychoendocrinological research has demonstrated that psychological factors significantly affect the course of a variety of medical conditions including dermatological disorders. However, there is no evidence that dermatological disorders are related to specific psychological traits. Rather, that the impact of skin disorders on quality of life indicates that the impairment of appearance associated with visible and sometimes disfiguring dermatological conditions creates significant psychosocial stress.

The relationship between psychological factors and skin disorders is further complicated by the fact that manipulations such as self-injurious skin picking may cause artificial dermatological lesions. Finally, a high proportion of patients report symptoms that are not adequately explained by a dermatological disease or a known pathophysiological mechanism, such as body dysmorphic disorders. The focus of the present paper is on psychological factors related to skin disorders. With respect to somatoform and artificial disorders, the interested reader is referred to other sources (e.g. Stangier & Ehlers, 2000).

Research evidence

Vulnerability to stress

There is evidence from a large number of studies that stressful life events, daily hassles and chronic stressors can significantly affect the manifestation and course of skin disorders (see also ‘Life events and health’ and ‘Stress and health’).

Type
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Information
Cambridge Handbook of Psychology, Health and Medicine , pp. 880 - 883
Publisher: Cambridge University Press
Print publication year: 2007

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References

Aktan, S., Ozmen, E. & Sanli, B. (1998). Psychiatric disorders in patients attending a dermatology outpatient clinic. Dermatology, 97, 230–4.Google Scholar
Bernard, J. D. (1994). Itch. mechanisms and management of pruritus. New York: McGraw-Hill.
Buske-Kirschbaum, A., Jobst, S., Wustmans, A.et al. (1997). Attenuated free cortisol response to psychosocial stress in children with atopic dermatitis. Psychosomatic Medicine, 59, 419–26.Google Scholar
Ehlers, A., Stangier, U. & Gieler, U. (1995). Treatment of atopic dermatitis. A comparison of psychological and dermatological approaches to relapse prevention. Journal of Consulting and Clinical Psychology, 63, 624–35.Google Scholar
Fortune, D. G., Richards, H. L., Kirby, B.et al. (2002). A cognitive–behavioural symptom management programme as an adjunct in psoriasis therapy. British Journal of Dermatology, 146, 458–65.Google Scholar
Hampel, P., Rudolph, H., Petermann, F. & Stachow, R. (2001). Stress management training for children and adolescents with atopic dermatitis during inpatient rehabilitation. Dermatology and Psychosomatics, 2, 116–22.Google Scholar
Hughes, J., Barraclough, B., Hamblin, L. & White, J. E. (1983). Psychiatric symptoms in dermatology patients. British Journal of Psychiatry, 143, 51–4.Google Scholar
Kent, G. & Keohane, S. (2001). Social anxiety and disfigurement: the moderating effects of fear of negative evaluation and past experience. British Journal of Clinical Psychology, 40, 23–34.Google Scholar
Leary, M. R., Rapp, S. R., Herbst, K. C., Exum, M. L. & Feldman, S. R. (1998). Interpersonal concerns and psychological difficulties of psoriasis patients: effects of disease severity and fear of negative evaluation. Health Psychology, 17, 530–6.Google Scholar
Picardi, A. & Abeni, D. (2001). Stressful life events and skin diseases: disentangling evidence from myth. Psychotherapy and Psychosomatics, 70, 118–36.Google Scholar
Picardi, A., Abeni, D., Melchi, C. F., Puddu, P. & Pasquini, P. (2000). Psychiatric morbidity in dermatological outpatients: an issue to be recognized. British Journal of Dermatology, 143, 920–1.Google Scholar
Rapp, S. R., Feldman, S. R., Exum, M. L., Fleisher, A. B. & Reboussin, D. M. (1999). Psoriasis causes as much disability as other major medical diseases. Journal of the American Academy of Dermatology, 41, 401–7.Google Scholar
Richards, H. L., Fortune, D. G., Main, C. J. & Griffiths, C. E. M. (2001). The contribution of perceptions of stigmatization to disability in patients with psoriasis. Journal of Psychosomatic Research, 50, 11–15.Google Scholar
Sarti, M. G. (1998). Biofeedback in dermatology. Clinics in Dermatology, 16, 711–14.Google Scholar
Schmid-Ott, G., Jaeger, B., Adamek, C.et al. (2001a). Levels of circulating CD8(+) T lymphocytes, natural killer cells, and eosinophils increase upon acute psychosocial stress in patients with atopic dermatitis. Journal of Allergy and Clinical Immunology, 107, 171–7.Google Scholar
Schmid-Ott, G., Jaeger, B., Meyer, S.et al. (2001b). Different expression of cytokine and membrane molecules by circulating lymphocytes on acute mental stress in patients with atopic dermatitis in comparison with healthy controls. Journal of Allergy and Clinical Immunology, 108, 455–62.Google Scholar
Staab, D., Rueden, U., Kehrt, R.et al. (2002). Evaluation of a parental training program for the management of childhood atopic dermatitis. Pediatric Allergy and Immunology, 13, 84–90.Google Scholar
Stangier, U. & Ehlers, A. (2000). Stress and anxiety in dermatological disorders. In Mostofsky, D. I. & Barlow, D. H. (Eds.). The management of stress and anxiety in medical disorders (pp. 304–33). Needham Heights, MA: Allyn & Bacon.
Stangier, U., Ehlers, A. & Gieler, U. (2003). Measuring adjustment to chronic skin disorders: validation of a specific self-report measure. Psychological Assessment, 15, 532–49.Google Scholar
Thompson, A. & Kent, G. (2001). Adjusting to disfigurement: processes involved in dealing with being visibly different. Clinical Psychology Review, 21, 663–82.Google Scholar
Trask, P. C., Paterson, A. G., Griffith, K. A., Riba, M. B. & Schwartz, J. L. (2003). Cognitive–behavioral intervention for distress in patients with melanoma: comparison with standard medical care and impact on quality of life. Cancer, 98, 854–64.Google Scholar
Wessley, S. & Lewis, G. (1989). The classification of psychiatric morbidity in attenders at the dermatology clinic. British Journal of Psychiatry, 155, 686–91.Google Scholar
Zacchariae, R., Oster, H., Bjerring, P. & Kragballe, K. (1996). Effects of psychologic intervention on psoriasis: a preliminary report. Journal of the American Academy of Dermatology, 34, 1008–15.Google Scholar

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