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[Psychological aspects in occupational dermatology].

Dermatologie (Heidelb)

January 2025

Sektion Berufsdermatologie, Zentrum Hautklinik, Universitätsklinikum Heidelberg, Ruprecht-Karls-Universität Heidelberg, Voßstr. 2, 69115, Heidelberg, Deutschland.

The prevalence of psychological disorders in the general population and, therefore, in dermatological and allergological patients continues to increase. Psychodermatology as a branch of dermatology is also becoming ever more relevant in occupational dermatology. Psychological comorbidities and cofactors like depression and anxiety disorders or stress are increasingly important, which must be considered regarding diagnostics and therapy selection.

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Biologics approved and in development for atopic dermatitis offer life-changing clinical efficacy with a relatively banal long-term safety profile requiring no laboratory monitoring. Biologic therapies also have their drawbacks, including high payor cost and the need to be administered as every other week subcutaneous injections. Addressing these concerns, studies of longer dosing intervals have been performed in the formal clinical trial setting and during real-world clinical care.

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SCORring atopic dermatitis (SCORAD) is widely used to assess the severity of atopic eczema, but score systems based on the entire body may be limited in effective monitoring and intervention. It is crucial to monitor moisture levels in each affected body part, but empirical research is still lacking. The objective of this study was to analyze the levels of stratum corneum hydration (SCH) and transepidermal water loss (TEWL) in atopic dermatitis (AD) patients, focusing on the presence and location of atopic lesions at different body sites.

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Background: Doxepin (DX) is used orally to relieve itching but can cause side effects like blurred vision, dry mouth, and drowsiness due to its antimuscarinic effect. To reduce these adverse effects and improve skin permeation, DX is being developed in topical formulations. This study aims to improve DX skin absorption by developing a microemulsion (ME) formulation (ME-DX).

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This cross-sequential study found that frequent intake of high-fat and high-protein foods was associated with higher odds of atopic dermatitis (AD). However, occasional intake across all three macronutrients significantly lowered AD odds, suggesting that moderation-not strict avoidance-may benefit AD management in allergic populations.

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