Modern approaches to the treatment of psychosomatic disorders associated with chronic dermatoses: a review
- 作者: Melnik E.P.1, Dorozhenok I.Y.1,2, Kayumova L.N.1, Lomonosov K.M.1
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隶属关系:
- The First Sechenov Moscow State Medical University (Sechenov University)
- Scientific Center for Mental Health
- 期: 卷 28, 编号 4 (2025)
- 页面: 391-400
- 栏目: DERMATOLOGY
- URL: https://journals.rcsi.science/1560-9588/article/view/350468
- DOI: https://doi.org/10.17816/dv677845
- EDN: https://elibrary.ru/ZHFORX
- ID: 350468
如何引用文章
详细
Most contemporary studies indicate a high prevalence of psychosomatic disorders in patients with dermatological conditions.
This article presents a systematic scientific data review of therapeutic approaches to psychosomatic disorders associated with chronic dermatoses. The review summarizes data from various studies analyzing psychosomatic aspects of psoriasis, acne, alopecia, lichen planus, and vitiligo, including stress-induced mechanisms of their development and progression, the impact of stigmatization on patients’ psycho-emotional state, as well as quality of life. Particular attention is given to nosogenic (secondary) and comorbid psychiatric disorders associated with the underlying dermatological condition, such as anxiety–depressive disorders, social phobia, and hypochondriacal reactions. The rationale for implementing comprehensive therapeutic strategies has been substantiated, including psychopharmacological interventions (selective serotonin reuptake inhibitors, atypical antipsychotics, anxiolytics), cognitive behavioral therapy, and psychoeducational programs. Multidisciplinary approaches to patient management are considered, integrating dermatological treatment with psychotherapeutic and psychopharmacological methods aimed at improving patients’ adaptation. The article also provides updated information on the treatment of chronic dermatoses.
The scientific data search was conducted in national and international scientific databases (PubMed, Scopus, MedLine, Embase, Cochrane, Russian State Library, Central Scientific Medical Library of I.M. Sechenov First Moscow State Medical University).
According to the scientific data analysis, psychosomatic disorders comorbid with dermatological diseases require timely detection and treatment. Modern approaches to the treatment of psychosomatic disorders associated with skin diseases involve comprehensive therapy encompassing both dermatological care and psychocorrectional components (psychotherapy and psychopharmacotherapy). Social support also plays an important role. The competent use of psychocorrectional methods in combination with traditional dermatological therapy significantly enhances overall treatment efficacy, improves patients’ quality of life, and reduces the frequency of exacerbations of chronic dermatoses.
作者简介
Ekaterina Melnik
The First Sechenov Moscow State Medical University (Sechenov University)
编辑信件的主要联系方式.
Email: katerina.melnik.5@gmail.com
ORCID iD: 0000-0002-2500-7861
SPIN 代码: 7418-1995
俄罗斯联邦, 4/1 Bolshaya Pirogovskaya st, Moscow, 119991
Igor Dorozhenok
The First Sechenov Moscow State Medical University (Sechenov University); Scientific Center for Mental Health
Email: idoro@bk.ru
ORCID iD: 0000-0003-1613-2510
SPIN 代码: 8701-7958
MD, Cand. Sci. (Medicine), Assistant Professor
俄罗斯联邦, 4/1 Bolshaya Pirogovskaya st, Moscow, 119991; MoscowLyailya Kayumova
The First Sechenov Moscow State Medical University (Sechenov University)
Email: avestohka2005@inbox.ru
ORCID iD: 0000-0003-0301-737X
SPIN 代码: 4391-9553
MD, Cand. Sci. (Medicine), Assistant Professor
俄罗斯联邦, 4/1 Bolshaya Pirogovskaya st, Moscow, 119991Konstantin Lomonosov
The First Sechenov Moscow State Medical University (Sechenov University)
Email: lamclinic@yandex.ru
ORCID iD: 0000-0002-4580-6193
SPIN 代码: 4784-9730
MD, Dr. Sci. (Medicine), Professor
俄罗斯联邦, 4/1 Bolshaya Pirogovskaya st, Moscow, 119991参考
- Siddiqui Z, Felder E, Hernandez K, et al. The psychosocial impact of pediatric vitiligo, psoriasis, eczema, and alopecia: a systematic review. Bull Menninger Clin. 2024;88(4):297–319. doi: 10.1521/bumc.2024.88.4.297 EDN: FRXXVH
- Dorozhenok IYu. Nosogenic psychosomatic disorders in patients with skin diseases. S.S. Korsakov J Neurol Psychiatry. 2023;123(4-2):36–43. doi: 10.17116/jnevro202312304236 EDN: XRNRCE
- Liu L, Lin NX, Yu YT, et al. Epidemiology of mental health comorbidity in patients with psoriasis: an analysis of trends from 1986 to 2019. Psychiatry Res. 2023;321:115078. doi: 10.1016/j.psychres.2023.115078 EDN: MDGJSY
- Dalgard FJ, Gieler U, Tomas-Aragones L, et al. The psychological burden of skin diseases: a cross-sectional multicenter study among dermatological out-patients in 13 European countries. J Invest Dermatol. 2015;135(4):984–991. doi: 10.1038/jid.2014.530 EDN: UFQAAN
- Bechman K, Hayes JF, Mathewman J, et al. Electronic screening for mental illness in patients with psoriasis. Br J Dermatol. 2023;189(2):246–248. doi: 10.1093/bjd/ljad141 EDN: MKVQVE
- Chen Y, Sun S, Yang H, et al. Global prevalence of mental health comorbidity in patients with acne: an analysis of trends from 1961 to 2023. Clin Exp Dermatol. 2025;50(6):1083–1093. doi: 10.1093/ced/llae531 EDN: ZTVBCK
- Molla A, Alrizqi H, Alharbi E, et al. Assessment of anxiety and depression in patients with acne vulgaris in medina: a case-control study. Clin Cosmet Investig Dermatol. 2021;14:999–1007. doi: 10.2147/CCID.S302311 EDN: XXIBVR
- Lauron S, Plasse C, Vaysset M, et al. Prevalence and odds of depressive and anxiety disorders and symptoms in children and adults with alopecia areata: a systematic review and meta-analysis. JAMA Dermatol. 2023;159(3):281–288. doi: 10.1001/jamadermatol.2022.6085 EDN: NHZZSH
- Cai XC, Wang SH, Wang CX, et al. Epidemiology of mental health comorbidity in patients with atopic dermatitis: an analysis of global trends from 1998 to 2022. J Eur Acad Dermatol Venereol. 2024;38(3):496–512. doi: 10.1111/jdv.19686 EDN: JABAZG
- Jalenques I, Lauron S, Almon S, et al. Prevalence and odds of signs of depression and anxiety in patients with lichen planus: systematic review and meta-analyses. Acta Derm Venereol. 2020;100(18):adv00330. doi: 10.2340/00015555-3660 EDN: JEOHLI
- Lai YC, Yew YW, Kennedy C, Schwartz RA. Vitiligo and depression: a systematic review and meta-analysis of observational studies. Br J Dermatol. 2017;177(3):708–718. doi: 10.1111/bjd.15199
- Alzeer FA, Alajlan A, Alshammari SA, et al. Depression and quality of life among Saudi patients with vitiligo: a descriptive quantitative review. Open Dermatol J. 2023;17:1–10. doi: 10.2174/18743722-v17-e230907-2023-5
- Kussainova A, Kassym L, Akhmetova A, et al. Vitiligo and anxiety: a systematic review and meta-analysis. PLoS One. 2020;15(11):e0241445. doi: 10.1371/journal.pone.0241445 EDN: EITTTZ
- Nasser MA, El Tahlawi SM, Abdelfatah ZA, Soltan M. Stress, anxiety, and depression in patients with vitiligo. Middle East Curr Psychiatry. 2021;28(1):28–63. doi: 10.1186/s43045-021-00120-w EDN: VVCCSC
- Li V, Frasier K, Woolhiser E, et al. Exploring the intersection of body dysmorphic disorder (BDD) and dermatological conditions: a narrative review. Dermatol Ther (Heidelb). 2024;14(10):2693–2708. doi: 10.1007/s13555-024-01256-3 EDN: ATPMYL
- Lönndahl L, Abdelhadi S, Holst M, et al. Psychological stress and atopic dermatitis: a focus group study. Ann Dermatol. 2023;35(5):342–347. doi: 10.5021/ad.22.035 EDN: DNZLIP
- Dorozhenok IYu, Snarskaya ES, Mikhailova M. Lichen planus and itch-related psychosomatic disorders. Russ J Skin Venereal Dis. 2021;24(6):543–551. doi: 10.17816/dv100612 EDN: WAOGSN
- Efanova EN, Vasilyeva EA, Kobylyanskaya NV, Kalinin MA. Analysis of the DLQI quality of life index (The Dermatology Life Quality Index) in patients with various dermatological nosologies. J Scientific Articles Health Education XXI Century. 2019;21(6):22–26. doi: 10.26787/nydha-2226-7425-2019-21-6-22-26 EDN: CGCEII
- Johns JR, Vyas J, Ali FM, et al. The Dermatology Life Quality Index as the primary outcome in randomized clinical trials: a systematic review. Br J Dermatol. 2024;191(4):497–507. doi: 10.1093/bjd/ljae228 EDN: APTKYD
- Hepat A, Chakole S, Rannaware A. Psychological well-being of adult psoriasis patients: a narrative review. Cureus. 2023;15(4):e37702. doi: 10.7759/cureus.37702 EDN: ZLJVFJ
- Blackstone B, Patel R, Bewley A. Assessing and improving psychological well-being in psoriasis: considerations for the clinician. Psoriasis (Auckl). 2022;12:25–33. doi: 10.2147/PTT.S328447 EDN: PIXTBY
- Nowowiejska J, Baran A, Grabowska P, et al. Assessment of life quality, stress and physical activity among patients with psoriasis. Dermatol Ther (Heidelb). 2022;12(2):395–406. doi: 10.1007/s13555-021-00662-1 EDN: XHZERG
- Haddad A, Zisman D. Comorbidities in patients with psoriatic arthritis. Rambam Maimonides Med J. 2017;8(1):e0004. doi: 10.5041/RMMJ.10279
- Soliman MM. Depressive, anxiety, stress, and insomnia symptoms in patients with psoriasis: a crosssectional study. Adv Dermatol Allergol. 2021;38(3):510–519. doi: 10.5114/ada.2020.98726 EDN: ISJOZR
- Lakshmy S, Balasundaram S, Sarkar S, et al. A cross-sectional study of prevalence and implications of depression and anxiety in psoriasis. Indian J Psychol Med. 2015;37(4):434–440. doi: 10.4103/0253-7176.168587 EDN: WRESCV
- López-Mejía R, Ramales-Montes EM, Ley-Silva LS, et al. Quality of life, depression and its relation to the severity in psoriasis. (In Spanish). Rev Med Inst Mex Seguro Soc. 2022;60(3):315–320.
- Schmitt J, Ford DE. Understanding the relationship between objective disease severity, psoriatic symptoms, illness-related stress, health-related quality of life and depressive symptoms in patients with psoriasis--a structural equations modeling approach. Gen Hosp Psychiatry. 2007;29(2):134–140. doi: 10.1016/j.genhosppsych.2006.12.004
- Dorozhenok IYu, Ilina EV. Psychosomatic aspects of psoriasis (review). Russ J Skin Venereal Dis. 2021;24(3):251–262. doi: 10.17816/dv71927 EDN: GWOWHT
- Alpsoy E, Ozcan E, Cetin L, et al. Is the efficacy of topical corticosteroid therapy for psoriasis vulgaris enhanced by concurrent moclobemide therapy? A double-blind, placebo-controlled study. J Am Acad Dermatol. 1998;38(2 Pt 1):197–200. doi: 10.1016/s0190-9622(98)70240-3
- Sukharev AV, Patrushev AV, Nazarov RN, Gutka VO. Opportunites of applying new generation antidepressants for correction of psychosomatic disorders upon chronic dermatoses. Effective pharmacotherapy. 2014;19:18–23. EDN: SYTZDP
- Potekaev NN, Lvov AN, Zhukova OV, et al. Psychosomatic disorders and quality of life in patients with chronic facial dermatoses and their dynamics with underlying application of medical camouflage. Russ J Clin Dermatol Venereol. 2017;16(5):58–72. doi: 10.17116/klinderma201716558-71 EDN: ZTSVCT
- Smulevich AB, Dorozhenok IYu, Romanov DV, Lvov AN. Psychopathology of mental disorders in a dermatological clinic (a model of mental pathology limited by the space of the skin). In: A.B. Smulevich, ed. Psychosomatic disorders in clinical practice. Moscow; 2014. P. 350–373. (In Russ.)
- Il’chevskaya EA, Krinitsyna YM, Sergeeva IG. Abnormalities of psycho-emotional state among patients with excoriated acne. Vestnik dermatologii i venerologii. 2017;(5):64–69. doi: 10.25208/0042-4609-2017-93-5-64-69 EDN: ZXVUZF
- Volkova NV, Glazkova LK, Retyunsky KY. Diagnostic and treatment algorithm including psychiatric comorbidity of acne vulgaris patients. Ural Med J. 2013;(8):103–110. EDN: RSUODH
- Romanova YuYu, Romanov DV, Brazhnikov АYu, et al. Perspective targets for secondary prevention of quality of life decrease and psychosomatic disorders in alopecia: results of an observational study. Russ J Preventive Medicine. 2019;22(5):104–111. doi: 10.17116/profmed201922051104 EDN: NKDMCL
- Michenko AB, Lvov AN, Ivanov OL, et al. Psychosomatic aspects of atopic dermatitis: classical canons and new ideas. Russ J Skin Venereal Dis. 2008;(4):11–17. EDN: JUYRGN
- Potekaev NN, Danilin I, Korsunskaya I, et al. Atopic dermatitis: psychosomatic aspects. Vrach. 2018;29(2):18–21. doi: 10.29296/25877305-2018-02-04 EDN: YRVECH
- Fiocco Z, Kupf S, Patzak L, et al. Quality of life and psychopathology in lichen planus: a neglected disease burden. Acta Derm Venereol. 2021;101(12):adv00619. doi: 10.2340/actadv.v101.442 EDN: XJPREW
- Arnold S, Fernando S, Rees S. Living with vulval lichen sclerosus: a qualitative interview study. Br J Dermatol. 2022;187(6):909–918. doi: 10.1111/bjd.21777
- Nasimi M, Ahangari N, Lajevardi V, et al. The quality of life and mental health status in patients with lichen planopilaris based on dermatology life quality index and general health questionnaire-28 questionnaires. Int J Womens Dermatol. 2020;6(5):399–403. doi: 10.1016/j.ijwd.2020.09.005 EDN: EOOTGU
- Perlamutrov YuN, Olkhovskaya KB, Vasilenko TI, Anokhina DI. Lichenoid dermatoses of the anogenital area. Russ J Clin Dermatol Venereol. 2022;21(5):646–654. doi: 10.17116/klinderma202221051646 EDN: CRHNFI
- Adamo D, Calabria E, Coppola N, et al. Psychological profile and unexpected pain in oral lichen planus: a case-control multicenter SIPMO studya. Oral Dis. 20221;28(2):398–414. doi: 10.1111/odi.13787 EDN: XSWSEI
- Tlish MM, Osmolovskaya PS. Optimization of therapy in patients with lichen ruber planus by means of cranial electrotherapy stimulation. Almanac Clin Med. 2021;49(8):516–524. doi: 10.18786/2072-0505-2021-49-046 EDN: VNOZBH
- Gaitán-Cepeda LA, Rivera-Reza DI, Villanueva-Vilchis MD. Neuroticism and psychological stress in patients suffering oral lichen planus: research evidence of psycho-stomatology? Healthcare. 2023;11(12):1738. doi: 10.3390/healthcare11121738 EDN: QXSZHY
- Dorozhenok IYu, Snarskaya ES, Shenberg VG. Comorbid mental disorders in patients with lichen planus. Russ J Skin Venereal Dis. 2015;18(5):38–42. doi: 10.17816/dv36997 EDN: UXLNCF
- Bibeau K, Ezzedine K, Harris JE, et al. Mental health and psychosocial quality-of-life burden among patients with vitiligo. JAMA Dermatology. 2023;159(10):1124. doi: 10.1001/jamadermatol.2023.2787 EDN: GRZPWS
- Zhang Y, Cai Y, Shi M, et al. The prevalence of vitiligo: a meta-analysis. PLoS One. 2016;11(9):e0163806. doi: 10.1371/journal.pone.0163806
- Naldi L, Pagani A, Alduini C. Vitiligo: epidemiology and economic impact. Dermatol Pract Concept. 2023;13(4S2):e2023315S. doi: 10.5826/dpc.1304S2a315S EDN: UMXUWQ
- Picardo M, Huggins RH, Jones H, et al. The humanistic burden of vitiligo: a systematic literature review of quality-of-life outcomes. J Eur Acad Dermatol Venereol. 2022;36(9):1507–1523. doi: 10.1111/jdv.18129 EDN: DWCWBB
- Augustin M, Gewiss C, Ben-Anaya N, Quality of life, disease burden and healthcare need of patients with vitiligo. Dermatologie (Heidelb). 2024;75(5):404–411. (In German). doi: 10.1007/s00105-024-05312-z EDN: CJTGWP
- Morrison B, Burden-Teh E, Batchelor JM, et al. Quality of life in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol. 2017;177(6):e338–e339. doi: 10.1111/bjd.15933
- Cupertino F, Niemeyer-Corbellini JP, Ramos-E-Silva M. Psychosomatic aspects of vitiligo. Clin Dermatol. 2017;35(3):292–297. doi: 10.1016/j.clindermatol.2017.01.001
- Alharbi MA. Identifying patients at higher risk of depression among patients with vitiligo at outpatient setting. Mater Sociomed. 2020;32(2):108–111. doi: 10.5455/msm.2020.32.108-111 EDN: KOTJTO
- Al-Janabi MA, Dorozhenok IYu, Lomonosov KM. Psychosomatic aspects of vitiligo. A review of the literature. Russ J Skin Venereal Dis. 2023;26(6):597–603. doi: 10.17816/dv487099 EDN: TTYMWQ
- Dahir AM, Thomsen SF. Comorbidities in vitiligo: comprehensive review. Int J Dermatol. 2018;57(10):1157–1164. doi: 10.1111/ijd.14055
- Bonotis K, Pantelis K, Karaoulanis S, et al. Investigation of factors associated with health-related quality of life and psychological distress in vitiligo. J Dtsch Dermatol Ges. 2016;14(1):45–49. doi: 10.1111/ddg.12729
- Ezzedine K, Eleftheriadou V, Jones H, et al. Psychosocial effects of vitiligo: a systematic literature review. Am J Clin Dermatol. 2021;22(6):757–774. doi: 10.1007/s40257-021-00631-6 EDN: KPNZQI
- Sarkar S, Sarkar T, Sarkar A, Das S. Vitiligo and psychiatric morbidity: a profile from a vitiligo clinic of a rural-based tertiary care center of Eastern India. Indian J Dermatology. 2018;63(4):281–284. doi: 10.4103/ijd.IJD_142_18
- Osinubi O, Grainge MJ, Hong L, et al. The prevalence of psychological comorbidity in people with vitiligo: a systematic review and meta-analysis. Br J Dermatol. 2018;178(4):863–878. doi: 10.1111/bjd.16049
- Carniciu S, Ha B, Gkini MA, et al. Secondary psychiatric disorders and the skin. Dermatological Rev. 2023;4(4):162–171. doi: 10.1002/der2.211
- Hamidizadeh N, Ranjbar S, Ghanizadeh A, et al. Evaluating prevalence of depression, anxiety and hopelessness in patients with Vitiligo on an Iranian population. Health Qual Life Outcomes. 2020;18(1):20. doi: 10.1186/s12955-020-1278-7 EDN: AGYLAM
- Wang KY, Wang KH, Zhang ZP. Health related quality of life and marital quality of vitiligo patients in China. J Eur Acad Dermatol Venereol. 2011;25(4):429–435. doi: 10.1111/j.1468-3083.2010.03808x
- Catucci Boza J, Giongo N, Machado P, et al. Quality of life impairment in children and adults with vitiligo: a cross-sectional study based on dermatology-specific and discase specific quality of life instruments. Dermatology. 2016;232(5):619–625. doi: 10.1159/000448656
- Dertlioglu SB, Cicek D, Balci DD, Halisdemir N. Dermatology life quality index scores in children with vitiligo: comparison with atopic dermatitis and healthy control subjects. Int J Dermatol. 2013;52(1):96–101. doi: 10.1111/j.1365-4632.2012.05616x
- Krüger C, Panske A, Schallreuter KU. Discase-related behavioral patterns and experiences affect quality of life in children and adolescents with vitiligo. Int J Dermatol. 2014;53(1):43–50. doi: 10.1111/j.1365-4632.2012.05656x
- Linthorst Homan MW, de Korte J, Grootenhuis MA, et al. Impact of childhood vitiligo on adult life. Br J Dermatol. 2008;159(4):915–920. doi: 10.1111/j.1365-2133.2008.08788.x
- Varzhapetyan AA, Dorozhenok IYu, Lomonosov KM. Vitiligo and comorbid psychosomatic disordes. Russ J Skin Venereal Dis. 2019;22(1-2):33–38. EDN: BATEUP
- Davletshina AYu, Lomonosov KM. Prospective methods of vitiligo treatment (literature review). Russ J Skin Venereal Dis. 2019;22(1-2):56–60. EDN: XCTBYD
- Koshevenko YN. Vitiligo: clinic, etiology, pathogenesis, treatment, rehabilitation, prevention. Moscow: Kosmetika i meditsina; 2002. Р. 492–500. (In Russ.)
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