It is known that psychological factors such as stress affect considerably many skin diseases with studies estimating the rate of skin conditions with a psychosomatic background up to 30%. Atopic dermatitis, previously called neurodermatitis, is the best example of skin disease influenced by psychological factors and modern research has elucidated the role of neuropeptides such as substance P in the pathogenesis of the disease. As our knowledge in psychoneuroimmunology is expanding, the role of neuropeptides, hormones, and neurotransmitters in psychodermatological disorders is becoming more evident.
Besides the common skin diseases that can be influenced by psychological factors a number primary psychiatric disorders can manifest on the skin as well. Body dysmorphic disorders with an altered perception of self and the delusion of parasitosis with patients believing their bodies being infested with parasites are typical examples of pathological conditions seen by dermatologists.
Experienced dermatologists with increased awareness of psychodermatological disorders and with a proper training can play a very important role, initially to suspect and establish the diagnosis and later to provide appropriate management.