Abstract

Psoriasis is a chronic inflammatory skin condition with significant physical and psychosocial comorbidity. A workshop of leading experts in dermatology and psychology with the purpose of better understanding the current role of psychological comorbidities in psoriasis was held by the International Psoriasis Council in November 2013. The role of stress reactivity with a focus on the hypothalamic-pituitary-adrenal axis was emphasized. While cognitive behavioral therapy remains the most extensively studied and successful treatment strategy in patients with psoriasis and various psychological comorbidities, new and innovative interventions such as online-based therapies have recently emerged. Strategies and recommendations toward approaching psychological comorbidities are discussed.

Highlights

  • Psoriasis is a chronic, relapsing and remitting inflammatory disease of the skin with a prevalence of 2–3% worldwide (Koo, 1999)

  • Andrea Evers discussed the connection between stress reactivity and psoriasis

  • A questionnaire study of dermatologists in The Netherlands demonstrated that on average, dermatologists referred only eight patients per year to a psychologist or other psychosocial professional and 50% of dermatologists have never referred to a psychologist or other psychosocial therapist (Evers et al, 2013)

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Summary

INTRODUCTION

Psoriasis is a chronic, relapsing and remitting inflammatory disease of the skin with a prevalence of 2–3% worldwide (Koo, 1999). The most common form of this disease, is characterized by scaly, erythematous, and infiltrated skin lesions, which are often pruritic and painful (Christophers and Mrowietz, 2003). The interplay between stress and other psychological comorbidities with psoriasis has been of common interest to both dermatologists and mental health professionals alike. The IPC has led an initiative to better define the association of various psychological comorbidities with psoriasis. In November 2013, a workshop was held in Boston, MA, which assembled a panel of global dermatology and psychology experts, with the objective to review the current research in the role of psychological comorbidities, focusing on stress and the interplay of the hypothalamic-pituitary-adrenal axis (HPAA) in psoriasis. The following report synthesizes the presentations and panel discussions from this meeting

HPAA ACTIVITY AND STRESS REACTIVITY IN PSORIASIS
PSYCHOLOGICAL INTERVENTION IN PSORIASIS
Findings
AUTHOR CONTRIBUTIONS
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