Abstract
BackgroundSkin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS). Data concerning the skin findings exclusively in post-BaS patients remain limited.MethodsSeventy post-BaS patients were examined for cutaneous abnormalities. The patients were divided into those with successful weight loss (% excessive body weight loss (EBWL) of at least 50%) and a non-successful group (%EBWL < 50%).ResultsForty-six patients with successful weight loss demonstrated a significantly lower prevalence of acanthosis nigricans on the neck, axillae and inguinal areas, keratosis pilaris (KP) and pebble fingers. However, a higher prevalence of alopecia was observed. After adjustment with patients’ factors, KP (adjusted odds ratio (aOR) = 0.21, 95%CI 0.06–0.74, p = 0.02) and pebble fingers (aOR = 0.09, 95%CI 0.01–0.89, p = 0.04) remained significantly less likely in patients with successful weight loss. Laboratory results comparing pre- and post-surgery values revealed significant decreases in fasting plasma glucose, hemoglobin A1c, and triglyceride and an increase of high-density lipoproteins in both groups. However, significant decreases of liver aminotransferases (AST and ALT) were observed only in the successful group (p = 0.04, 0.003). Nonetheless, a decrease in vitamin B12 (p = 0.01) was observed in the successful group.ConclusionWeight loss after BaS provided an improvement for metabolic profiles. Successful weight reduction resulted in better skin improvement. However, nutritional supplements may be necessary.Trial registrationThai Clinical Trials Registry TCTR20171003002. Registered October 3. 2017, retrospectively registered.
Highlights
Skin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS)
Skin signs associated with obesity may be divided into those that occur as a result of insulin resistance such as acanthosis nigricans (AN) [2,3,4] acrochordons [3, 4], and keratosis pilaris (KP) [3,4,5]
Where we found evidence of a significantly increased or decreased odds in those with successful surgery, we adjusted these for age, sex, and underlying diseases and reported these adjusted odds ratio, 95% confident interval, and p-values
Summary
Skin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS). Data concerning the skin findings exclusively in post-BaS patients remain limited. Substantial increases in the prevalence of patients with obesity has raised the public awareness over decades. Obesity has various impacts on the skin, including changes in skin physiology, myriads of skin manifestations and aggravation of skin diseases. Skin signs associated with obesity may be divided into those that occur as a result of insulin resistance such as acanthosis nigricans (AN) [2,3,4] acrochordons [3, 4], and keratosis pilaris (KP) [3,4,5]. I.e. candidiasis and the inflammatory skin disorders namely psoriasis and hidradenitis suppurativa are observed at higher frequency and severity in patients with obesity [3, 4, 6]. Skin manifestations due to metabolic derangements such as gouty tophi are seen [3, 4]
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