How obesity influence psoriasis severity in developing countries

Abstract

Psoriasis is a common chronic inflammatory skin disease with a complex pathogenesis consisting of a genetic component, immune dysfunction, and environmental factors. It is associated with numerous comorbidities including psoriatic arthritis, cardiovascular disease, metabolic syndrome, and obesity. The dietary habits in industrialized nations promote high-fat, high-salt, and high-sugar diets with excess caloric intake resulting in an obesity epidemic. Meta-analyses have shown that (1) genetically higher BMI increased the odds of psoriasis occurrence; (2) obesity is associated with higher incidence and prevalence of psoriasis as well as psoriasis severity; (3) obesity is associated with lower efficacy to anti-TNF agents and may predict biologic treatment discontinuation; and (4) weight loss through diet and physical exercise may improve pre-existing psoriasis. Obesity is one of the major public health concerns due to its upward trend in both developing and developed countries. In developing countries, the consequence of obesity not only affects health but also creates a burden on individual and national healthcare budgets. The prevalence of overweight and obesity in developing countries is increasing faster than the world average. This fast-paced growth has been accompanied by notable increases in the burden of non-communicable diseases (NCDs). While obesity is gradually increasing in developing countries, where NCD is yet to implement. If proper NCD program is not implement in right time, severity of psoriasis will increase with increase prevalence of obesity.