Does Stress Influence Itching in Psoriatic Patients?

Abstract

Background: It is known that stress may exacerbate psoriasis. Pruritus is one of the most bothersome symptoms of psoriasis. Objective: The aim of this study was to evaluate if stress provokes itching in psoriatic subjects. Patients and Methods: 79 patients (44 males, 35 females) in an acute stage of psoriasis were included into the study. The severity of psoriasis was assessed by the Psoriasis Area and Severity Index (PASI). The psychosocial stress was measured by the Social Readjustment Rating Scale by Holmes and Rahe and by a self-assessment method. For the evaluation of itching two scales were used: a Visual Analogue Scale and a questionnaire. Results: There were significant correlations between the two scales used for pruritus evaluation (p < 0.00001) as well as between the methods employed for stress assessment (p < 0.00001). Stressful life events in the month before psoriasis exacerbation were reported by 50 patients (63.3%). Pruritus was present in 71 individuals (89.9%). Patients who experienced heavy or extremely heavy stress suffered statistically more frequently (p < 0.05) from pruritus than patients without stress. Significant correlations between the severity of stress and the intensity of itching were observed in the patients studied (p = 0.015). Conclusion: The results suggest that stress may provoke and intensify itching in psoriatic patients. Further investigations on the exact mechanism of stress effects on itching in psoriasis are required.

Plasma Neuropeptides and Perception of Pruritus in Psoriasis

“…Moreover, a treatment with anti-histaminics rarely brings relief, and this seems to be connected with its sedative effect rather than with anti-histaminic properties (11). In our previous study we found that the presence and intensity of pruritus in patients with psoriasis may be related to perceived stress (14). Recently, Nakamura et al (15) demonstrated increased density of nerve fibres within the skin of psoriatic patients with pruritus compared with non-pruritic patients.…”

“…All patients underwent careful dermatological examination: the severity of psoriasis was assessed according to the Psoriasis Area and Severity Index (PASI) (20) and pruritus intensity according to a standard Visual Analogue Scale (VAS) (II). Although the VAS is a highly subjective scale, it has been widely accepted for pruritus intensity assessment (18,21) and was also used by our group in previous studies on pruritus (11,13,14). Both disease severity and pruritus intensity were measured on the same day as blood sampling.…”

Patients with Psoriasis Feel Stigmatized

“…The severity of depressive symptoms was rated based on the Beck's Depression Inventory (BDI) (14). The level of stress was measured within one month before disease exacerbation and was assessed according to the Holmes & Rahe Social Readjustment Rating Seale (SRRS) ( 15) as well as aeeording to the Stress Self-assessment Scale (no stress, mild, moderate, severe and extremely severe stress) (16). Detailed results of QoL, depression and stress have been published elsewhere (4,6).…”

Trauma und psychische Belastung bei dermatologischen Patienten

“…PTSD-Symptome als Hautreaktionen manifestieren können [14]. Verschiedene Studien fanden eine Assoziation von Stress mit der Schwere der Hautkrankheit sowie der Häufigkeit und Intensität des Juckreizes [5,7,21,23]. Auch traumatische Ereignisse in der Lebensgeschichte scheinen einen Einfluss auf die Erkrankung zu haben.…”