Background: An association of mental stress with atopic dermatitis is widely accepted. However, no long-term evaluation of psychophysiological reactivity over the course of disease has yet been performed. Objective: We examined whether atopic dermatitis patients have an increased psychophysiological reactivity compared to healthy controls and in between acute and disease-free phases, and whether they differ in psychological state and trait variables. Methods: Fifteen patients with atopic dermatitis underwent a stress test during acute exacerbation and after symptom improvement and were compared to matched controls. Results: Psychophysiological responsesto stress were not stronger in the patient group than in the controls. Nevertheless, the patients had a higher heart rate and lower vagal activity throughout the resting and stress phases at both examination times. The patients showed significantly higher anxiety, depression and emotional excitability, and self-ratings of inactivity clearly distinguished acute phases from remission. Conclusion: There is an increased vegetative excitability level in patients with atopic dermatitis, which cannot be attributed solely to increased disease activity.

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