Psychological Morbidity in Chronic Dermatological Disorders: A Review

Abstract

Skin diseases not only manifest physically but also significantly impact mental and emotional well-being due to the close biological connection between the skin and brain. Psychodermatology, a field that bridges dermatology and psychiatry, addresses the psychological aspects of dermatological disorders, which can profoundly affect quality of life. This review explores the psychological morbidity associated with common dermatological conditions, including acne vulgaris, alopecia areata, atopic dermatitis, hidradenitis suppurativa, leprosy, melasma, psoriasis, urticaria, and vitiligo. A comprehensive literature search was performed and studies assessing quality of life in common chronic dermatological disorders were analyzed. Patients with chronic skin conditions often experience anxiety, depression, social withdrawal, and stigmatization, which can impair their personal and professional lives. Psychometric tools like the Dermatology Life Quality Index (DLQI) and Patient Health Questionnaire-9 (PHQ-9) are essential for assessing the impact on quality of life and identifying psychiatric comorbidities. Despite the recognized link between dermatological conditions and mental health, these aspects often receive insufficient attention in clinical practice. This review highlights the need for a multidisciplinary approach that integrates psychological support with dermatological treatment. Effective management strategies, including cognitive behavioral therapy, psychotropic medications, and habit reversal therapy, are discussed as crucial components of patient care.

Keywords: Chronic dermatological disorders; depression; neurocutaneous axis; psychodermatology; psychotherapy; quality of life.

Figure 1

Flowchart depicting the neurocutaneous axis in skin inflammation. HPA: hypothalamic–pituitary–adrenal axis, CRH: corticotrophin-releasing hormone, CRH-R: CRH receptor, NTs: neurotransmitters, IL- Interleukin, TNF- Tumor necrosis factor, CNS- central nervous system, IFN- Interferon

Figure 2

Bar graph showing mean impairment of DLQI in various dermatoses