Author(s): RomeroTalams H, Aminian A, Corcelles R, Fernandez AP, Schauer PR,
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Abstract BACKGROUND: Psoriasis is a chronic inflammatory skin disease known to be associated with obesity and metabolic syndrome. Single case reports and small series suggest remission or improvement after bariatric surgery, hypothetically through a GLP-1 mediated mechanism. The objective of this study was to investigate on the effect of bariatric surgery on the clinical behavior of psoriasis in obese patients. METHODS: A total of 33 morbidly obese individuals with psoriasis who were on active medical treatment were identified. Demographic characteristics and follow-up data were extracted from our database. Medication usage and percentage of affected body surface area (\%ABSA) were recorded preoperatively and at least 6 months after bariatric surgery. RESULTS: Nine (27.2\%) patients were on systemic therapy at baseline. At a mean follow-up time of 26.2±20.3 months, a mean excess weight loss (EWL) of 48.7± 26.6\% was achieved. This was associated with improvement of psoriasis based on downgrade of medication and \%ABSA in 30.3\% and 26.1\% of patients, respectively. In total, 13 of 33 patients (39.4\%) had improvement based on either criteria. Eight (24.2\%) patients were not on any psoriasis medication at the latest follow-up (P = .001). Older age at the time of surgery (54.8±8.1 versus 48.1±10.4 years, P = .047), Roux-en-Y gastric bypass versus nonbypass procedures (52.4\% versus 16.7\%, P = .043), and greater EWL (64.2±26.0\% versus 43.4± 23.6\%, P = .036) predicted improvement. Only 1 (3\%) patient experienced worsening after surgery. CONCLUSION: Almost 40\% of our cohort showed improvement of psoriasis several months after bariatric surgery. Improvement is directly related to the degree of postoperative weight loss and is associated with the Roux-en-Y configuration. Copyright © 2014 American Society for Bariatric Surgery. Published by Elsevier Inc. All rights reserved.
This article was published in Surg Obes Relat Dis
and referenced in Journal of Clinical & Experimental Dermatology Research