Stressful major life events and chronic urticaria: Its role in induction or exacerbation of the disease

Background: The skin and central nervous system are derivatives of embryonic ectoderm. There is an etiological factor of stressful life events in various skin diseases such as chronic urticaria through psychosomatic mechanisms. Many observations and case series are reported in favor of this opinion. Objectives: To evaluate the stressful life events within one year, six months and a month preceding onset or exacerbation of lesions in chronic idiopathic urticaria cases enrolled in this study. Material and Methods: It is an Observational descriptive questionnaire-based study, which included minimum of 50 patients of chronic idiopathic urticaria and important stressful events were noted in these subjects using Gurmeet Singh's presumptive stressful life events (PSLE) scale. Results: Out of 50 cases, stressful life events preceded the exacerbation of the chronic urticaria in 16 (32%) patients. Amongst them 12 (24%) showed slight degree and four (8%) showed moderate degree of stress and none of the cases reported great degree of stress. Among 16 cases, eight (50%) cases noticed exacerbation within six months of experiencing stressful life event with higher degree of severity in older age group (p = 0.004). Financial loss or problem was the most common stressful life event seen in four out of 16 cases (25%) (p = 0.000). Few desirable events were also found as stressors in four cases accounting for 25%. Conclusion: These results support association between psychological factors and exacerbation of the disease. The need for stress management programs in high stress scores to cope up with the stressful events, will further help in reducing the morbidity.