Aspecte patogenetice ale bolilor dermatologice pe fundal de stres

Abstract

Introducere. Stresul este considerat un factor crucial care creşte incidenţa şi progresia bolilor de piele, iar psihoder-matologia este un domeniu relativ nou al medianei contemporane ce studiază aspecte fundamentale şi clinice ale bolilor de piele, incidenţa cărora este în creştere în ultimii ani. Scop şi obiective. Elucidarea mecanismelor si verigilor pa-togenetice de impact, prin care stresul induce şi agravează bolile cutanate pentru a fi ţintite prin terapia patogenetic argumentată. Material şi metode. În procesul de cercetare a problemei sindromului Post Covid a fost revizuită literatura de specialitate disponibilă pe platformele informaţionale internaţionale precum PubMed, MedScape, Medline şi Hinari. De asemenea, au fost utilizate resursele informaţionale disponibile ale Bibliotecii Medicale a USMF „Nicolae Testemiţanu”. Rezultate. Celulele imune - limfoc-itele, macrofagele, keratinocitele, celulele dendritice exprimă receptori pentru neurotransmiţători şi hormoni, iar răspunsul imun poate fi modulat neurochimic. Afecţiunile pielii induse de stres includ acneea, alopecia areata, derma-tita atopică, psoriazisul, rozaceea. O categorie de tulburări psihologice asociate cu simptome dermatologice - tulburarea obsesiv-compulsivă sau anxietatea conduc la acnee, exco-riaţii, tricotilomanie iar tulburările dermatologice pot avea simptome psihice asociate, cum ar fi: anxietatea, depresia şi alte tulburări de dispoziţie pe fundal de eczemă cronică, psoriazis, vitiligo. Concluzii. Pielea conţine un echivalent periferic al axei hipotalamo-hipofizo-suprarenale. Stresul şi bolile de piele sunt conectate prin mecanisme patogenet-ice - inflamator, de hipersensibilitate, autoimun, endocrin formând mai multe cercuri vicioase care necesită confirmări fundamentale şi clinice.

Introduction. Stress is considered a crucial factor that increases the incidence and progression of skin diseases, and psychodermatology is a relatively new field of modern medicine that studies the fundamental and clinical aspects of skin disorders, whose global incidence has been rising in recent years. Objective. Elucidation of the key mechanisms and pathogenetic pathways through which stress induces and aggravates skin diseases, in order to target them with rational, pathogenetically based therapy. Material and methods. In the research process on the issue of Post-COVID Syndrome, the specialized literature available on international informational platforms such as PubMed, MedScape, Medline, and Hinari was reviewed. Additionally, the informational resources available at the Medical Library of 'Nicolae Testemitanu' State University of Medicine and Pharmacy were used. Results. Immune cells - lymphocytes, macrophages, keratinocytes, and dendritic cells - express receptors for neurotransmitters, and the immune response can be modulated neurochemically. Stress - induced skin conditions include acne, atopic dermatitis, psoriasis, and rosacea. Psychological disorders associated with dermatological symptoms - such as obsessive-compulsive disorder or anxiety - can lead to acne, excoriations, and trichotillomania. Conversely, dermatological disorders may be accompanied by psychological symptoms such as anxiety, depression, and other mood disorders, especially in the context of chronic eczema, psoriasis, and vitiligo. Conclusion. The skin contains a peripheral equivalent of the hypothalamic-pituitary-adrenal axis. Stress and skin diseases are connected through pathogenetic mechanisms - inflammatory, hypersensitivity-related, autoimmune, forming multiple vicious cycles that require both fundamental and clinical validation.