Michael L. Shelling, Robert S. Kirsner
Dermatologists now recognize that patients with psoriasis have an associated increased risk for and prevalence of hypertension, diabetes, dyslipidemia, obesity, and vascular disease. However, changes in management of patients with psoriasis have lagged behind advances in knowledge. Specifically, the complex relationship between psoriasis and obesity has become a focus of study. Patients with a higher body mass index (BMI) have an increased risk for new-onset psoriasis, and the higher the BMI (obesity), the higher the Psoriasis Area Severity Index at disease onset.1 In some patients, obesity follows the onset of psoriasis,2 possibly because of the particular inflammatory cytokine milieu. In this issue, Jensen et al3 identify the benefits of a low-energy diet in patients with psoriasis, with a trend toward reduced disease severity and significant improvement in quality of life. These findings may help us embrace a more comprehensive approach to patients with psoriasis.
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