Psoriasis is a common chronic inflammatory skin disease, which is shaped by genetics and environmental factors, including stress. Numerous studies and case reports have suggested that stress is a major contributor to the development and exacerbation of psoriasis. In recent decades, much progress has been made expanding our knowledge on the pathophysiological processes linking stress to psoriasis. The main pathways involve the hypothalamic-pituitary-adrenal axis, sympathetic-adrenal-medullary axis, peripheral nervous system and immune system. The aim of this review is to summarize current knowledge on the relationship between stress and psoriasis and the underlying mechanisms.
© 2019 British Association of Dermatologists.