Itching and stress: a comparative analysis of psychosomatic relationships in chronic dermatoses, skin neoplasms, and cutaneous toxic reactions

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Abstract

Background: Itching significantly impacts patients’ quality of life, causing stress, anxiety, or depression. Psychological stress and subsequent modulation of the immune and nervous systems significantly influence itching. Stress can worsen itching and vice versa, leading to a vicious cycle that can significantly impair a patient’s quality of life.

Objective: Evaluation of the relationship between itching and stress in patients with itchy and non- itchy dermatoses, skin toxic reactions, and melanocytic skin neoplasms.

Materials and methods: In a multicenter, cross-sectional, observational, continuous, non-randomized, controlled study, patients with common itchy and non-itchy dermatoses, melanocytic skin lesions, and skin toxic reactions (n=597) were examined compared with a control group (n=216). A clinical dermatological examination, assessment of the intensity of itching using a numeric rating scale (0 to 10 points), a survey about the presence of stressful events over the past year, and a psychometric examination using the PSS-10 scale for the assessment of the level of perceived stress were conducted.

Results: The groups differed statistically significantly (<0.001) in the frequency of stressful events over the past year. Patients with skin toxic reactions reported stressful events most frequently (65.6%), followed by patients with psoriasis and acne (48.5% and 48.1%, respectively). The groups differed significantly in the level of perceived stress, with the highest rates observed in patients with skin toxic reactions, lower rates in those with acne and atopic dermatitis, and the psoriasis group ranking third. When assessing the association between itching and stress in different patient groups (Table 3), the strongest correlation was found in patients with melanocytic nevi, but it was not statistically significant. A moderately significant correlation was found for psoriasis and atopic dermatitis.

Conclusion: Thus, this study demonstrates a significant association between itching and stress, which significantly contributes to the disease burden in patients with cutaneous toxic reactions. Comprehensive therapy for patients with itching should be aimed not only at correcting this subjective symptom but also at improving stress management.

About the authors

Anna V. Michenko

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation; Lomonosov Moscow State University; International Institute of Psychosomatic Health; Institute of Plastic Surgery and Cosmetology

Author for correspondence.
Email: amichenko@mail.ru
ORCID iD: 0000-0002-2985-5729
SPIN-code: 8375-4620

Cand. Sci. (Med.), Sssociate Professor, Department of Dermatovenereology and Cosmetology; Dermatovenereologist, Medical Research and Educational Center; Dermatovenereologist; Dermatovenereologist

Russian Federation, Moscow; Moscow; Moscow; Moscow

Andrey N. Lvov

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation; Lomonosov Moscow State University

Email: alvov@mail.ru
ORCID iD: 0000-0002-3875-4030
SPIN-code: 1053-3290

Dr. Sci. (Med.), Professor, Head of the Department of Postgraduate Studies and Residency, Professor of the Department of Dermatovenereology and Cosmetology; Chief Researcher, Medical Research and Education Center

Russian Federation, Moscow; Moscow

Larisa S. Kruglova

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation

Email: kruglovals@mail.ru
ORCID iD: 0000-0002-5044-5265
SPIN-code: 1107-4372

Dr. Sci. (Med.), Professor, Head of the Department of Dermatovenereology and Cosmetology, Rector

Russian Federation, Moscow

E. A. Kuzma

International Institute of Psychosomatic Health

Email: miss.fedulina1998@yandex.ru
ORCID iD: 0000-0002-8079-8002

Dermatovenereologist

Russian Federation, Moscow

A.-S. S. Abdullaeva

Central State Medical Academy of the Administrative Directorate of the President of the Russian Federation

Email: abdullaevasara@mail.ru
ORCID iD: 0000-0002-8080-1929
SPIN-code: 8310-0354

Resident of Department of Dermatovenereology and Cosmetology

Russian Federation, Moscow

Anastasia S. Allenova

I.M. Sechenov First Moscow State Medical University

Email: allenova_a_s@staff.sechenov.ru
ORCID iD: 0000-0003-0751-0073
SPIN-code: 7765-7631

Cand. Sci. (Med.), Senior Researcher

Russian Federation, Moscow

Dmitry V. Romanov

I.M. Sechenov First Moscow State Medical University; Mental Health Research Center

Email: newt777@mail.ru
ORCID iD: 0000-0002-1822-8973
SPIN-code: 2412-9077
Scopus Author ID: 25650916200

Dr. Sci. (Med.), Professor, Department of Psychiatry and Psychosomatics, ICM; Leading Researcher, Department for the Study of Borderline Mental Pathology and Psychosomatic Disorders

Russian Federation, Moscow; Moscow

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