Progressive muscle relaxation therapy for atopic dermatitis : objective assessment of efficacy

Abstract

Psychological stress has been reported to play an important role in atopic dermatitis (AD). Psychological interventions have been reported to be effective in managing patients with AD. However, objective assessments of the efficacy of these interventions are lacking. The goal of our study was to validate the efficacy of relaxation therapy (RT) in patients with AD and to evaluate the serologic parameters that can serve as objective measures of the efficacy of RT. Twenty-five patients with AD were randomly assigned to either an RT group (n=15) or a control group (n=10). The RT group received one month of treatment consisting of progressive muscle relaxation (PMR) together with conventional treatments, while the control group was treated with only conventional treatments. We measured psychological stress, including depression, anxiety, interaction anxiousness, and private body consciousness, and clinical severity, including the eczema area and severity index (EASI), pruritus, andloss of sleep (LOS) at baseline and after 1 month in both the RT and control groups. In addition, we evaluated serum levels of nerve growth factor (NGF), neuropeptide Y (NPY), and Th2 cytokines (IL-4, IL-5, and IL-13) at baseline and after 1 month in both the RT andcontrol groups. At baseline, among the psychological parameters, only anxiety was positively correlated with the pruritus score (state anxiety (SA): R=0.496, p=0.014; trait anxiety (TA): R=0.423, p=0.04). Additionally, serum levels of NPY were inversely related to the state-trait anxietyinventory (STAI) (SA: R=-0.475, p=0.019; TA: R=-0.418, p=0.042) and pruritus scores (R=-0.451, p=0.035) at baseline. After one month of PMR therapy, the degree of pruritus and loss of sleep (LOS) were significantly decreased only in RT group (p<0.001 for both). SA scores showed significant improvement after treatment only in RT group (p=0.005). There were no significant changes in serologic parameters, including NGF, NPY, and Th2 cytokines in bothgroups, after treatment. Although there were no significant changes in serologic parameters after treatment, NPY might be closely related with high levels of anxiety in AD at baseline. PMR might effectively reduce pruritus and LOS in AD patients through reducing anxiety. Thus PMR could be auseful adjunctive modality for the management of AD.