National Crisis-Induced Psychological Stress and Increased Herpes Zoster Incidence: A 10-Year Retrospective Study

Introduction: Psychological stress is known to affect dermatological conditions, but its impact during national crises is not well established. Objectives: To assess the association between crisis-induced stress and the incidence of infectious and inflammatory skin diseases, focusing on herpes zoster. Methods: A retrospective cross-sectional study was performed using emergency room records from Hadassah Medical Center, Israel. Skin-related visits were compared between October and December 2023 (national crisis), and the same months in 2014–2022: between the COVID-19 lockdowns (March–May 2020, December 2020–February 2021) and pre-pandemic years (2014–2022). Logistic regression models, adjusted for age and sex, evaluated disease incidence. Results: Among 1,644 patients, infectious skin diseases increased significantly during the October–December 2023 crisis (odds ratio (OR)=2.106; P<0.001), mainly due to herpes zoster (OR=2.616; P=0.009). No significant change was observed for inflammatory skin diseases. During COVID-19 lockdowns, no significant difference was found, likely reflecting reduced healthcare utilization. Conclusions: National crisis-related stress was associated with higher incidence of infectious skin diseases, particularly herpes zoster, but not with inflammatory conditions. These findings support targeted interventions, including vaccination and stress management, during crises.