Psychoneuroimmunologic aspects of skin diseases.

As mental and psychological issues are important in the development of many dermatologic diseases, these factors are of special interest in research. Psychoneuroimmunology is the study of interaction between psychological processes and the nervous and immune systems of the human body, and it was comprehensively described for the first time about 30 years ago. Communication between the mind and the skin involves the psycho-immuno-endocrine-cutaneous system, encompassing the activities of the brain, the immune system and the skin, with participation of different neuropeptides, interleukins, and immune system messengers. Many common dermatologic diseases have some form of psychomediated pathogenesis that partially accounts for the development of skin lesions. There is a link between emotional stressors (acute or chronic), psychiatric diseases, and dermatoses (e.g., psoriasis, atopic dermatitis, urticaria, viral warts, herpes simplex, vitiligo, acnes, alopecia, prurigo, etc.) and different cytokines and mediators produced in the skin and involved in their pathogenesis. A prominent role is played by those agents that belong to the hypothalamic-pituitary-adrenal axis.