PSYCHOLOGICAL AND PSYCHOPHYSIOLOGICAL ASPECTS OF PSORIASIS

Psoriasis is a chronic skin disorder of unknown cause, which is comple x on psychologic, social, and cultural levels. Many studies document t he impact of psoriasis, which can be associated with painful feelings of embarassment and stigmatization, anticipation of being rejected, an d at times interference with work, relationships, and daily activities . Depression can be an important issue for psoriasis patients, and scr eening for it by the clinician is of utmost importance; it may be asso ciated with severe pruritus and may alter itch perception. Four cluste rs of studies bearing on stress and the onset and exacerbation of psor iasis are discussed, especially those involving a life-event methodolo gy and those that attempt to define a psychoendocrine or psychoneuroim munologic pathway. Treatment approaches to psychosocial issues may inv olve group therapies, individual psychotherapy, and behavior therapy; of greatest importance are improved patient education and an empathic doctor-patient relationship.