[A case of atopic dermatitis-the biopsychosocial view].

Abstract

Background: Atopic dermatitis is perhaps the most comprehensively studied skin disease in psychosomatic medicine and psychoneuroimmunology. Its biopsychosocial conceptualization incorporates psychodynamic as well as behavioral and systemic considerations. At the same time, there is also extensive biological knowledge of the neuroendocrine-immune control of barrier and immune function, characterized through animal experiments and translational clinical studies. Integrating this knowledge into clinical routine, however, represents a challenge.

Objectives: The biopsychosocial implications of atopic dermatitis are discussed using a concrete case as an example.

Materials and methods: Case presentation and narrative review of relevant psychopathogenetic models and psychoneuroimmunological pathomechanisms.

Results and conclusion: Using a case of stress-exacerbated atopic dermatitis, the contribution of acute and chronic stressors to the development and worsening of skin inflammation is discussed. Particular attention is paid to the role of the pituitary hypothalamic adrenal axis and neurogenic inflammation as central drivers of barrier disruption and immune imbalance in atopic dermatitis.