Digital psychotherapeutic interventions to reduce dermatological symptom burden: Development and testing of MindMySkin

Background: Although cognitive and behavioral factors significantly impact dermatological outcomes, psychobehavioral interventions remain inaccessible and underused. Objective: To develop and test a psychobehavioral intervention (MindMySkin) delivered via a mobile application. Methods: Needs assessment, evidence-based module development, and formative user-centered evaluation were conducted in participants with eczema, psoriasis, or chronic urticaria. The developed prototype modules were further iteratively refined following additional qualitative and quantitative feedback. Results: 27 participants contributed to 24 1:1 interviews and 231 responses between June 2023 and November 2024. Modules were highly rated (median score 4 or 5/5) for utility, interest, understandability, and recommendation for inclusion, underscoring strong acceptability. Participants valued the informative content and conversational tone but highlighted skepticism toward reflection exercises and oversimplification of patient difficulties. Design challenges include balancing time demanding but effective modules with shorter more appealing content. The final intervention comprised 74 modules addressing illness coherence, symptom management, functional impairment, emotional impairment, and the patient-physician relationship. Limitations: No participant reviewed the full program and modules were assigned, limiting insights on voluntary adherence. Conclusion: This study establishes the unmet need for psychotherapeutic support and demonstrates the acceptability, appropriateness, and usability of a self-administered psychobehavioral intervention in improving dermatological care.