Understanding psychocutaneous disease: psychosocial & psychoneuroimmunologic perspectives

The study of psychocutaneous disease involves a comprehensive understanding of the complex and often neglected psychoneuroimmunologic components and pathways. Patients suffering from the many disorders that blur the interface between the fields of psychiatry and dermatology are often misdiagnosed and mistreated because of the lack of knowledge and awareness of the underlying disease-causing mechanisms. Individuals with psychodermatologic disease also experience a general lower overall quality of life as it has negative implications on psychosocial, emotional, and cognitive well-being. Factors like early life interactions, body image dissatisfaction, and societal stigma play a crucial role in the development of psychosocial stress experienced by individuals with visible skin conditions. This heightened level of stress serves as a trigger in the activation of the hypothalamic-pituitary-axis (HPA), mediating immune responses that influence cutaneous disease severity and exacerbation. In order to improve the quality of life and treatment outcomes of the patient population impacted by psychodermatologic disease, it is essential to better understand the complex interplay between the various psychosocial factors and pathophysiologic pathways involved.