Introduction: Allergic contact dermatitis (ACD) is a form of late hypersensitivity reaction of skin contact with allergens. As an inflammatory skin disease, ACD has a negative impact on the quality of life and there is a need to elucidate the etiopathogenetic factors of the disease, whereby using the psychoneuroimmunological (PNI) approach can be helpful. Psychological stress (PS), as a component of PNI, leads to aggravation of the contact hypersensitivity reaction. In response to the perception of stress, cortisol secretion is enhanced by activation of the hypothalamic­pituitary­adrenal (HPA) axis. Furthermore, the proinflammatory cytokines interleukin 6 (IL­6) and tumor necrosis factor alpha (TNF­α) play a role in activating the HPA axis as well as initiating and maintaining inflammatory responses. Recent studies show that IL6, IL­1, and TNF­α values are increased in serum of patients with contact dermatitis, as well as in keratinocyte cell culture. Methods: The study examined the association of PNI factors (morning salivary cortisol as a biomarker of stress, serum IL­6 and TNF­α, stress intensity with "Perceived Stress Scale" (PSS) questionnaire, quality of life of dermatology patients with "Dermatology Life Quality Index" (DLQI)) with the disease severity evaluated using the Hand Eczema Extent Score (HEES) and the duration of disease in hand ACD patients, as well as the differences between patients with ACD and atopic disease and those without atopy. Results: This study examined the association of PNI factors (morning salivary cortisol as a biomarker of stress, serum IL­6 and TNF­α, stress intensity with "Perceived Stress Scale" (PSS) questionnaire, quality of life of dermatology patients with "Dermatology Life Quality Index" (DLQI)) with the disease severity evaluated using the Hand Eczema Extent Score (HEES) and the duration of disease in hand ACD patients, as well as the differences between patients with ACD and atopic disease and those without atopy. Conclusion: This study is the first so far, to our knowledge, in which a detailed analysis of PNI factors in patients with hand ACD was conducted. The results show that patients with ACD have lower values of morning cortisol in saliva and higher stress intensity, which indicates changes in the balance of the HPA axis and indirectly affects the quality of life and severity of the clinical picture of teh disease. The results of the research provide more knowledge about ACD and contribute to and emphasize the importance of a multidisciplinary approach to treatment, thus improving the quality of life of these patients.