[Atopic dermatitis and psychological stress]

Hautarzt. 2003 Oct;54(10):925-9. doi: 10.1007/s00105-003-0609-z.
[Article in German]


Atopic dermatitis (AD) is a chronic relapsing inflammatory skin disease. Its main features are eczematous skin lesions with a typical distribution and severe pruritus. Allergens, skin irritants, systemic or local infections, environmental pollutants and hormonal changes have a role in the pathophysiology of AD. A further important trigger factor for both intrinsic and extrinsic AD is emotional stress. Recently published observations point to direct psychoneuroimmunological and -endocrinological mechanisms: Psychological stress causes a transient increase of peripheral blood eosinophil count and an increase in both CD8+/CD11b+ and CLA+ T-cells. In addition, stress changes the cytokine and the hormone profile with increased levels of IFN-gamma and IL-5, and decreased levels of cortisol in AD patients in contrast to healthy controls. These findings underline the role of immunological changes and a possible suppressed hypothalamic-pituitary-adrenal (HPA) axis closing the loop for the final aggravation of AD.

Publication types

  • Comparative Study
  • English Abstract

MeSH terms

  • Adult
  • Allergens / immunology
  • CD8-Positive T-Lymphocytes / immunology
  • Child
  • Dermatitis, Atopic / blood
  • Dermatitis, Atopic / etiology*
  • Dermatitis, Atopic / immunology
  • Dermatitis, Atopic / physiopathology
  • Eosinophils / immunology
  • Female
  • Humans
  • Hydrocortisone / blood
  • Hypothalamo-Hypophyseal System / physiology
  • Interferon-gamma / blood
  • Interleukin-5 / blood
  • Male
  • Personality Inventory
  • Pituitary-Adrenal System / physiology
  • Psychoneuroimmunology
  • Stress, Psychological / blood
  • Stress, Psychological / complications*
  • Stress, Psychological / immunology
  • Stress, Psychological / physiopathology
  • Surveys and Questionnaires
  • T-Lymphocytes / immunology
  • Time Factors


  • Allergens
  • Interleukin-5
  • Interferon-gamma
  • Hydrocortisone