Obesity Promotes and Complicates PsoriasisWednesday, August 11, 2010
Psoriasis is a chronic, autoimmune disease that causes red, scaly patches to appear on the skin, and affects 2-3% of the population in Western countries.
Several previous reports have linked an association between obesity and psoriasis and studies indicate that obese patients with psoriasis are more difficult to treat.
This complex relationship between posoriasis and excess weight is now reviewed by Bremmer and colleauges from the University of Portland, Oregon, in an article released online by the Journal of the American Academy of Dermatology.
The authors performed a literature review and identified numerous studies that support an association between obesity and psoriasis.
As the authors note in their discussion:
“Several mechanisms by which psoriasis could lead to obesity have been proposed, including increased social isolation, increased unhealthy dietary habits, increased depression, increased alcohol consumption, and decreased physical activity, particularly secondary to psoriatic arthritis. In fact, one case-control study found that both males and females with psoriasis report consuming significantly more total fat, saturated fat, and alcohol than their respective healthy controls.”
While weight gain has been associated with increase in psoriasis prevalence and symptoms, weight loss has been described to substantially reduce skin lesions and other symptoms of psoriasis, suggesting a causative link in the association between excess weight and psoriasis.
Not only are obese patients with psoriasis more difficult to treat, they also appear to be more likely to experience adverse effects to medications and are less likely to respond favorably to systemic therapies.
Unfortunately, as the authors point out, there is currently little evidence to guide clinicians to the best treatment choices for obese patients with psoriasis.
Given the frequency of psoriasis that I see in my obesity clinic, I can only confirm that this certainly appears to be an area that would warrant further study.
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Bremmer S, Van Voorhees AS, Hsu S, Korman NJ, Lebwohl MG, Young M, Bebo BF Jr, Blauvelt A, & National Psoriasis Foundation (2010). Obesity and psoriasis: From the Medical Board of the National Psoriasis Foundation. Journal of the American Academy of Dermatology PMID: 20692722
Wednesday, August 11, 2010
It would be interesting to check to see if these patients may have underlying thyroid issues. I can’t get to the details of studies, but there is research suggesting a link between autoimmune thyroid (notably Hashimoto’s thyroiditis) and psoriasis.
Anecdotally – my own psoriasis improved greatly after I was diagnosed with and started treatment for Hashimoto’s. The psoriasis clearing up happened prior to any weight loss in my case. I considered it a wonderful bonus from starting thyroid treatment. While I know it could be purely coincidental, I have not has a flare in the skin component of psoriasis since I started on my thyroid meds 4 years ago. I say skin component as I also have some form of arthritis, exact type unidentified with psoriatic being one of several possibilities.