JMIR Publications

ABSTRACT

Background:

Chronic dermatologic conditions such as psoriasis, atopic dermatitis, and hidradenitis suppurativa are associated with a high burden of psychiatric comorbidity, including depression, anxiety, and suicidality. Despite growing awareness of the psychosocial impact of skin diseases, mental health needs remain under-addressed in dermatologic care. Digital technologies (including teledermatology, mobile health applications, and internet-delivered psychotherapies) offer promising avenues for integrating psychotherapeutic and psychiatric interventions into dermatology. However, the scope, effectiveness, and implementation of such informatics-based approaches remain poorly mapped in the literature.

Objective:

This scoping review aimed to systematically identify, categorize, and synthesize studies on digital psychotherapeutic and psychiatric interventions targeting patients with dermatologic conditions, with a focus on clinical, mental health, and implementation outcomes.

Methods:

Following the PRISMA-ScR guidelines, we conducted a comprehensive search across five databases (MEDLINE, Embase, Web of Science, PsycINFO, and Google Scholar) for articles published up to March 2025. Studies were included if they involved dermatologic patients and assessed interventions that combined a digital informatics component (e.g., telehealth, apps, AI, virtual platforms) with a psychotherapeutic or psychiatric element (e.g., cognitive behavioral therapy, mindfulness, consult-liaison psychiatry). Eligible study designs included clinical trials, observational studies, and mixed-methods research. Data were extracted systematically and methodological quality was assessed using Joanna Briggs Institute (JBI) tools.

Results:

Out of 15,176 records identified, 11 studies met inclusion criteria. Most targeted adults with psoriasis, using platforms such as web-based cognitive behavioral therapy (iCBT), mindfulness modules, mobile apps, and virtual assistants. Mental health outcomes commonly assessed included depression, anxiety, and illness perceptions, while dermatologic outcomes included a clinician assessed score : Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI) scores, which represents a patient-reported questionnaire. Interventions incorporating iCBT and compassion-based strategies reported moderate improvements in psychological distress and dermatologic quality of life. However, adherence varied (dropout rates ranged from 10-46%) and long-term outcomes were rarely reported. Implementation challenges included digital literacy barriers, low integration into routine care, and limited data on health equity. Quality appraisal revealed moderate to high methodological rigor, although many studies were small and non-randomized.

Conclusions:

Informatics-based psychotherapeutic and psychiatric interventions represent a promising frontier in psychodermatology, with early evidence suggesting feasibility and potential clinical benefit. Digital platforms may expand access to mental health support and improve holistic care for dermatology patients. However, significant gaps remain in terms of equity, long-term effectiveness, integration into clinical workflows, and adaptation for diverse populations. Future research should focus on rigorous, inclusive trials and the development of hybrid models that blend digital and face-to-face care to ensure sustainable and equitable impact.