Psychiatric morbidity and pemphigus: a review of theories and literature on pathogenesis

Skin diseases are very common in the community and a large number of general practice visits are due to dermatological problems. Most dermatologists believe that psychiatric problems are frequent among subjects coming to their attention and several studies on dermatological patients have revealed that they prevalently suffered from psychiatric disorders. However, there are only few articles in the literature dealing with stress induced pemphigus or psychiatric troubles associated with pemphigus. The relationship between pemphigus and psychiatric disorders is still a matter of debate. The first question is whether the association is circumstantial or causal. Subsequently, it should be clarified if psychogenic factors can be considered an inducing factor for pemphigus onset, or a possible complication of this skin disease, or a comorbidity of it, or, in the end, an adverse reaction to conventional therapy for pemphigus. In any case, further studies are needed to investigate the underlying mechanism linking psychiatric diseases and pemphigus.