Indonesian Journal of Biomedicine and Clinical Sciences
Vol 58 No 3 (2026)

The relationship between psychological stress, salivary cortisol levels, and psoriasis severity

Nyoman Suryawati (Udayana University)
Ketut Kwartantaya Winaya (Department of Dermatology and Venereology, Faculty of Medicine, Udayana University/Ngoerah Hospital)
I Gusti Ayu Agung Praharsini (Department of Dermatology and Venereology, Faculty of Medicine, Udayana University/Ngoerah Hospital, Bali, Indonesia)
I Nyoman Wande (Department of Clinical Pathology, Faculty of Medicine, Udayana University/Ngoerah Hospital, Bali, Indonesia)



Article Info

Publish Date
03 Aug 2026

Abstract

Psychological stress has been associated with psoriasis, possibly through neuroendocrine pathways involving the hypothalamic-pituitary-adrenal axis. However, evidence on salivary cortisol levels in psoriasis vulgaris remains inconsistent, and data from Indonesian populations remain limited. This analytical cross-sectional study was conducted at Ngoerah Hospital, Bali, Indonesia, from July to October 2024. The study included 44 patients with psoriasis vulgaris and 41 non-psoriasis controls. Psychological stress was assessed using the Perceived Stress Scale; psoriasis severity was evaluated using the Psoriasis Area and Severity Index; and salivary cortisol levels were measured using an enzyme-linked immunosorbent assay. Between-group comparisons and correlation analyses were performed to evaluate the relationship between psychological stress, salivary cortisol levels, and psoriasis severity. Psychological stress scores and salivary cortisol levels did not differ significantly between the psoriasis and non-psoriasis groups. In the psoriasis group, salivary cortisol levels were not correlated with psychological stress. However, salivary cortisol levels showed a weak negative correlation with psoriasis severity, as measured by the PASI score (r=-0.33; p=0.03). This study found no significant correlation between salivary cortisol levels and psychological stress, but revealed a weak negative correlation between salivary cortisol levels and psoriasis severity.

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Journal Info

Abbrev

InaJBCS

Publisher

Subject

Biochemistry, Genetics & Molecular Biology Health Professions Immunology & microbiology Medicine & Pharmacology Neuroscience

Description

Indonesian Journal of Biomedicine and Clinical Sciences (InaJBCS) aims to promote the translational of basic research into clinical studies and of clinical evidence into practice. InaJBCS publishes studies that substantially enhance our standing of disease etiology and physiology; the development of ...