Peer-review started: January 1, 2015
First decision: February 7, 2015
Revised: September 30, 2015
Accepted: November 4, 2015
Article in press: November 3, 2015
Published online: February 2, 2016
The debut, progression and maintenance of skin disease are related to stress (acne, alopecia areata, atopic dermatitis, lichen planus, psoriasis, urticaria, vitiligo, herpes, hyperhidrosis, pemphigus, rosacea or seborrheic dermatitis). Environmental, socio-professional, life events are representing external factors. Personality, previous experiences, traits of anxiety are individual factors influencing the state of stress. Perceived stress could be more harmful especially in “high reactors” to stress. Coping abilities to stress could be increased in social programs. There was a recent interest in measuring the quality of life in the last years. There are dermatology and disease specific questionnaires that could help. Out-patients have less time to wait for very sophisticated procedures. They expect faster results. For simple, acute diseases it is important to have a good communication and good understanding of the instructions to get results as soon as possible. For chronic diseases a strong long-term alliance is needed, so the patients should revisit for his benefit and not for giving up. Small questions regarding potential stressful events, impact on the quality of life, stigmatization, the level of symptoms (pruritus), psychiatric comorbidities (anxiety, depression), short questionnaires for quality of life give us a better picture, personalize the doctor-patient relationship and could influence the choice of treatment. Many skin disorders could be seen from a psychosomatic point of view and the final goal, especially for the chronic diseases, is to improve through our treatments the impact on the quality of patient’s life.
Core tip: The debut, progression and maintenance of skin disease are related to stress. Besides external factors, individual factors could influence the state of stress. Perceived stress, high reactors to stress, coping abilities, quality of life questionnaires are some directions to discuss. Out-patients have different needs and expectations than in-patients. Good communication, empathy, personalized questions, short questionnaires could make a strong, long-term doctor-patient relationship with better results and satisfaction for both sides.