NEUROIMMUNOENDOCRINE RESPONSE TO STRESS AND ITS CONTRIBUTION TO THE PATHOGENESIS OF SKIN DISEASES

Abstract

The neuroimmunoendocrine response to psychological stress plays a key role in the pathogenesis of dermatological diseases. This integrative literature review summarizes recent findings on the interactions between stress and skin diseases, focusing on the neuroimmune-cutaneous system (NICS) and its clinical implications. Psychological stress activates the hypothalamic-pituitary-adrenal (HPA) axis, triggering the release of stress hormones, neuropeptides, and inflammatory cytokines, which disrupt skin immunity and exacerbate diseases such as psoriasis and atopic dermatitis. This bidirectional relationship is compounded by the psychosocial burden of visible skin lesions, which negatively affect self-esteem and mental health, creating a feedback loop of stress and inflammation. Key findings highlight the role of neurotransmitters such as serotonin and substance P in amplifying immune responses and pruritus, as well as the prevalence of psychiatric comorbidities among dermatological patients. Evidence supports the integration of stress management techniques such as psychotherapy and mindfulness into dermatological therapies to interrupt this cycle and improve patient outcomes. This review highlights the need for holistic clinical approaches that address both the physical and emotional aspects of dermatological conditions, emphasizing the importance of further research into neuroimmunoendocrine pathways and psychodermatological interventions to improve patient care and quality of life.

DOI: https://doi.org/10.56238/sevened2025.011-028