REVIEW article
Front. Med.
Sec. Dermatology
Volume 12 - 2025 | doi: 10.3389/fmed.2025.1614863
The Role of Psychological Stress in the Pathogenesis of Psoriasis
Provisionally accepted
- 1Tianjin Academy of Traditional Chinese Medicine Affiliated Hospital, Tianjin, China
- 2Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
- 3Department of Dermatology, First Hospital, Hebei Medical University,, Shijiazhuang, China
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Psoriasis is an immune-mediated dermatosis characterized by systemic inflammation and multifactorial pathogenesis. Among its many triggers, psychological stress has emerged as a pivotal yet underappreciated contributor to disease onset and exacerbation. Although the pathomechanisms by which psychological stress is involved in the pathogenesis of psoriasis are not clear, evidence suggests a regulatory role of psychologic stress in immune functions, including increasing expression levels of proinflammatory cytokines and intracellular adhesion molecule-1 (ICAM-1), and decreasing anti-inflammatory cytokines and the function of glucocorticoid receptors, possibly in part via activation of corticotropin-releasing hormone (CRH)-proopiomelanocortin (POMC)-adrenocorticotropic hormone (ACTH)-corticosteroids axis. In addition, the onset and/or worsening of psoriasis can also be attributed to psychological stress-induced defective epidermal permeability barrier function. Moreover, the bidirectional nature of this relationship often leads to a vicious cycle of flare-ups and psychological distress, further complicating patient management and quality of life. This review aims to synthesize current evidence on the relationship between stress and psoriasis, examining mechanistic pathways through which psychosocial stress contributes to immune dysregulation in psoriatic pathology. It also underscores the significance of psychological interventions in the management of psoriasis.
Keywords: Psoriasis, psychological stress, psoriasis area and severity index, intervention, PSAI
Received: 03 May 2025; Accepted: 19 Jul 2025.
Copyright: © 2025 Lei, Gong, Wang, Zhang, Zhang and Man. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Mao-Qiang Man, Dermatology Hospital, Southern Medical University, Guangzhou, Guangdong, China
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