Psoriasis And Weight

Introduction

Psoriasis is a long term non-contagious skin condition that affects males and females to an equal degree. Approximately 2 out of 100 people in the UK are affected by psoriasis. It can develop at any age, but is most prevalent amongst 20 to 30 year olds and 50 to 60 years old adults.¹

What is psoriasis?

Psoriasis is characterised by the presence of flaky patches on skin covered in scales. This disease is a result of an increase in skin cells turn-over, which eventually builds up and causes these patches to form. 

It is suggested that psoriasis is an inherited trait, albeit the genetic basis is still unclear. The severity of the disease depends on each individual. For some, it may be a minor problem, but for others, the patches can be extremely itchy and irritating, which may have a big impact on their standard of life. It is also common to develop psoriasis arthritis, which is characterised with a painful sensation, tenderness, swelling, and inflamed joints and connective tissues.¹ 

There are no current cures for psoriasis. However, there are treatments and therapies to reduce irritation and improve the appearances of patches on skin. In the majority of cases, your doctor will prescribe you with vitamin D creams or steroid ointments. 

If these topical medications do not seem to decrease symptoms, phototherapy can be introduced. Phototherapy involves the action of exposing your skin to different types of ultraviolet lights to minimise apparent patches.¹ 

Symptoms

Depending on the skin colour, psoriasis can either appear red or pink with white or silver scales or purple or dark brown with grey scales. The majority of the people who are affected only developed small patches, although some people also develop larger patches. There are several types of psoriasis, and people can be affected with more than one type of psoriasis at one time. The most common types are as below:²

• Plaque psoriasis are dry skin lesions (plaques) that are apparent on the elbows, knees, scalp, and lower back  

• Scalp psoriasis is a type of plaque psoriasis which occurs on the entire scalp or only affects certain scalp areas. In extremely severe cases, this can lead to temporary hair loss

• Nail psoriasis causes the nails to have small dents and pits, discolourations, and abnormal growth

• Guttate psoriasis mainly affects the chest, arms, legs, and scalp, where it can progress into plaque psoriasis. It is more prevalent in children and teenagers

• Inverse (flexural) psoriasis affects parts of the skin that are folded or creased, such as the armpits, groin, between the buttocks, and under the breasts

Some less common types of psoriasis usually involve the formation of pus-filled blisters called pustules. These types are described below.²

• Pustular psoriasis is a rare type of psoriasis which causes pustules to form at different parts of the body

• Generalised pustular psoriasis (von Zumbusch psoriasis) is a serious type of psoriasis and requires medical treatment immediately. The pustules normally contain white blood cells which might resurface every few days and cause adverse health effects such as fatigue, fever, and weight loss

• Palmoplantar pustulosis is a condition where pustules appear on the palms of the hands and soles of the feet

• Erythrodermic psoriasis affects all parts of the body. It can cause an extreme itchiness and a burning irritation which may need emergency medical assistance

Obesity cannot cause psoriasis

As psoriasis is an autoimmune condition, obesity does not have a direct impact on the development of psoriasis. However, a strong link between obesity and psoriasis has been observed. It is likely that the inflammation amplified by obesity triggers psoriasis, which is an inflammatory condition.³ 

Obesity is a pro-inflammatory state

Inflammatory mediators, named adipokines, are derived from the fatty adipose tissue. Adipokines display pro-inflammatory capabilities. The increase in adipokines in an obese individuals contributes to the low-grade inflammatory state, which doubles the risks of developing psoriasis. Therefore, obesity is an important risk factor in creating a predisposed condition favourable for psoriasis to develop.⁴  

State of pro-inflammation increases the chance of psoriasis flare-ups

One of the cells in the immune system are T-helper cells. Their function is to detect and help in fighting against foreign particles and invading germs on the skin. In psoriasis patients, the T-cells attack the normal skin cells as they mistake them for diseased cells. This forces the epidermal layers of the skin to rapidly produce new skin cells in response to the damages. This abnormal production of skin cells leads to overabundance and eventually psoriasis.^5,6 

In obese psoriasis patients, the increase in the formation of fatty adipose tissues creates a pro-inflammatory state. The pro-inflammatory state triggers the activation of cells within the immune system, which eventually leads to the activation of T-helper cells. Hence, there is an increase in the number of T-cells. This means more T-cells will attack the normal skin cells which leads to more rapid production of new skin cells. Therefore, the pro-inflammatory state from obesity or even adipose tissue formation from weight gain leads to an increase in the chance of psoriasis flare-ups.^5,6 

Conclusion

It still remains unclear what the exact causes of the disease are. Current research is looking into the environmental factors which could be possible root causes. Similarly, the exact roles of genetics are still uncertain. Despite the lack of knowledge surrounding the mechanism of psoriasis, treatments are available to help ease the symptoms and improve quality of life. It is important to have regular check-ups with your doctor, especially if your symptoms seem to have worsened or if your medications do not look like they are improving your blisters and skin patches.