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. 2020 Nov;18(11):1280-1298.
doi: 10.1111/ddg.14328.

Skin and Psychosomatics - Psychodermatology today

Uwe Gieler  1 , Tanja Gieler  2 , Eva Milena Johanne Peters  3 , Dennis Linder  4
Affiliations

Skin and Psychosomatics - Psychodermatology today

Uwe Gieler et al. J Dtsch Dermatol Ges. 2020 Nov.

Abstract

Modern psychodermatology relies on the bio-psycho-social disease model in psychosomatics, according to which biological, psychological and social factors (on various levels, from molecules to the biosphere) play a major role in the disease pathogenesis through complex, non-linear interactions over the entire disease course. It is nowadays experimentally proven that "emotions get into the skin". Recent research shows close anatomical, physiological and functional connections between skin and nervous system, already known to be ontogenetically related. These connections are reflected in many skin diseases where psychological and somatic etiological factors are closely intertwined. A holistic approach by the physician should do justice to this interdependence; biological, psychological and social factors should be adequately taken into account when taking anamnesis, making a diagnosis and choosing a therapy. The "visibility" of the skin organ bestows dermatology a special position among the various other clinical subjects, and renders a holistic, psychosomatic approach to the patient that is particularly important. The life course belongs also to modern psychodermatological approaches. Based on the modern psychodermatology concept, other corresponding sub-areas such as psychogastroenterology, psychocardiology etc. have emerged. After the theoretical part of this article, some selected skin diseases are discussed in more detail from the psychosomatic point of view.

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Conflict of interest statement

None.

Figures

Figure 1
Figure 1
Main issues that contribute, according to modern psychosomatics, to the pathogenesis of a skin disease.
Figure 2
Figure 2
Hypothetical connection between psoriasis and depression.
Figure 3
Figure 3
Life course approach and cumulative life course impairment (CLCI) (modified after [40]).
Figure 4
Figure 4
Self‐inflicted skin lesions – diagnostic classification.
See this image and copyright information in PMC

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