Psoriasis and Obesity: A ‘Special’ Relationship With Clinical Impact

At the recent American Academy of Dermatology (AAD) annual meeting, a presentation called “Psoriasis Beyond the Skin: Obesity, Metabolism, and Cardiovascular Risk,” featuring Joel M. Gelfand, MD, of the University of Pennsylvania in Philadelphia, highlighted the growing recognition of psoriasis as a systemic disease.

In this MedPage Today video, Gelfand discusses the unique and causal relationship between obesity and psoriasis — and what it means for patient care.

Following is a transcript of his remarks:

Hello everyone, I’m Joel Gelfand. I’m a dermatologist at the University of Pennsylvania here in Philadelphia. And I just want to speak to you briefly about obesity and psoriasis.

In my mind, psoriasis and obesity have a strong relationship that’s distinct from its relationship with other inflammatory diseases. We know from both genetic work and observational epidemiological studies that obesity is a causal risk factor for developing psoriasis. It makes the disease more extensive and more severe. It makes patients more likely to develop psoriatic arthritis over time and less likely to respond to therapies.

On top of all that, we know our patients with psoriasis are more prone to diabetes and insulin resistance, and certainly obesity plays a role in that outcome as well. And recently we published a paper in the British Journal of Dermatology, showing that people who inherit genes that make it as if they’re taking a GLP-1 agonist, that they are less likely to develop psoriasis and psoriatic arthritis.

And this is not the case for other inflammatory diseases of the skin, gut, and joints, so a very special and specific relationship between psoriasis and obesity. And I think now with the advent of GLP-1 agonists, as well as new data on diet — the Mediterranean diet, for example — there are new ways to help people with psoriasis not only improve their skin, but also their overall health.