%0 Journal Article
%T The Effect of Weight Loss in Obese Patients with Chronic Stable Plaque-Type Psoriasis
%A Wanjarus Roongpisuthipong
%A Marinya Pongpudpunth
%A Chulaporn Roongpisuthipong
%A Natta Rajatanavin
%J Dermatology Research and Practice
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/795932
%X Background. Chronic plaque psoriasis is frequently associated with obesity. The effect of a low-calorie diet on psoriasis has not been investigated. Objective. The objective was to investigate whether moderate weight loss increases the therapeutic response to topical treatment in obese patients with chronic stable plaque-type psoriasis. Material and Method. A 24-week clinical trial was conducted in 10 patients. The efficacy of a low-calorie diet with topical treatment was compared with baseline in obese patients with chronic stable plaque-type psoriasis. The primary measure of clinical response was the Psoriasis Area and Severity Index at weeks 12 and 24. Results. At week 12, the mean reduction in body weight was 9.6 percent. There was an improvement from baseline of 50 percent or more in the Psoriasis Area and Severity Index in 50 percent of the patients. The responses as measured by improvements in the Psoriasis Area and Severity Index were paralleled by improvements in global assessments by the physician and the patients and in the Dermatology Life Quality Index. Conclusion. Obese patients with chronic stable plaque-type psoriasis increase their response to a low-calorie diet. Lifestyle modifications, including a low-calorie diet, may supplement the pharmacologic treatment of obese psoriasis patients. 1. Introduction Chronic plaque-type psoriasis is a chronic inflammatory skin disorder that affects approximately 2 percent of the world¡¯s population and is associated with obesity in 13¨C34% of cases [1, 2]. The relative risk of psoriasis has been reported to be directly related to body mass index (BMI), and positive correlation between psoriasis severity and BMI has been established [3]. Moreover, epidemiological studies have reported associations between psoriasis and the metabolic syndrome in a dose-response manner. Worldwide, the incidence of obesity and metabolic syndrome has increased dramatically in recent decades [4, 5]. Obesity and metabolic syndrome are a cluster of risk factors including dyslipidemia, hypertension, and insulin resistance and are strong predictors for cardiovascular disease, diabetes mellitus, and stroke [6, 7]. Indeed, psoriasis has also been reported to be an independent risk factor for myocardial infarction, especially in young patients [8]. Psoriasis and obesity share similar mediators of inflammation, mainly tumor necrosis factor-¦Á (TNF-¦Á) and interleukin-6 (IL-6). The effectors of adipocytic and psoriatic inflammation, mainly adipocytes and macrophages, are derived from a common mesothelial origin [9]. Furthermore,
%U http://www.hindawi.com/journals/drp/2013/795932/