Psychological interventions in atopic dermatitis

Atopic dermatitis is a common skin disease that places a large burden on patients and their families. It is characterized as a chronic inflammatory disease that most commonly begins in early childhood. Prevalence is high, especially in children, and increases in western countries. Originally, treatments for atopic dermatitis were primarily topical corticosteroid agents. Recently, topical calcineurin inhibitors, such as tacrolimus and pimecrolimus, have been applied successfully. The impact of this disease on quality of life has long been underestimated. Problems in coping with the visibility of the affected skin, with the itch and scratching are common. The chronic condition of the disease and its impact on daily life adds to the life stressors of patients. Psychological interventions for atopic dermatitis include patient education, relaxation, habit reversal training, stress management, and cognitive behavioral therapy. Scientific evidence for the effects of psychological interventions is scarce. Methodological quality of reported trials is generally low. Nevertheless, a review of the studies indicates that psychological interventions reduce eczema severity, itching intensity and scratching behaviour. Moreover, recent methodological sound studies report a positive effect on quality of life for structured group programmes.