Stress-Induced Interaction of Skin Immune Cells, Hormones, and Neurotransmitters

The document reviews the impact of psychological stress on skin diseases, highlighting the role of skin immune cells, hormones, and neurotransmitters in stress-induced skin responses. It discusses how stress mediators like cortisol, ACTH, and CRH from the hypothalamus-pituitary-adrenal axis activation can induce skin immune responses, with skin cells themselves secreting these hormones and contributing to inflammation. The local skin CRH-POMC-ACTH-corticosteroids axis is particularly significant in these responses. Additionally, skin cells such as keratinocytes and fibroblasts can produce and respond to hypothalamic and pituitary signal peptides and express receptors for various neurotransmitters, neurotrophins, and neuropeptides, linking psychoneuroimmunologic mechanisms. The review suggests that understanding this complex network is crucial as it is active in many skin diseases, such as psoriasis, atopic dermatitis, chronic urticaria, warts, hair loss, and acne. Stress can affect disease severity and exacerbation frequency, and psychiatric treatments may benefit dermatologic conditions influenced by stress. The review aims to provide a comprehensive background for further research in skin psychoneuroimmunology.