It. Harvima et al., ASSOCIATION OF CUTANEOUS MAST-CELLS AND SENSORY NERVES WITH PSYCHIC STRESS IN PSORIASIS, Psychotherapy and psychosomatics, 60(3-4), 1993, pp. 168-176
Association of stress with psoriatic skin symptoms was studied in 13 p
atients with psoriasis by dividing the patients into low- and high-str
ess groups based on their clinical examination and answers to three qu
estionnaires (General Health Questionnaire, a somatization scale, and
a life change questionnaire). This study focused on skin mast cells an
d sensory nerves which are the principal components in neurogenic infl
ammation. Mast cells were stained enzyme-histochemically for tryptase
and chymase, and neuropeptides substance P (SP), vasoactive intestinal
peptide (VIP), and calcitonin gene-related peptide (CGRP) were demons
trated immunohistochemically. Compared to the low-stress group (n = 7)
, the patients in the high-stress group (n = 6) had more severe skin a
nd joint symptoms. Furthermore, mast cells positive for chymase activi
ty were prominently reduced, but tryptase-positive mast cells only sli
ghtly decreased in the lesional skin of the high-stress group. A simil
ar tendency was also observed in the nonlesional skin. In the papillar
y dermis of the lesional skin, both VIP- and CGRP-immunoreactive nerve
s could be observed in the high-stress group whereas in the low-stress
group these nerve fibers were hardly visible in the corresponding are
a. No association of SP with stress was observed. This study suggests
that psychic stress is associated with exacerbation of psoriasis, and
stress may induce alterations in the psoriatic lesions by increasing t
he neuropeptide content with a concomitant decrease in the activity of
neuropeptide-degrading enzymes, especially mast cell chymase.