Bariatric Surgery May Help Limit Psoriasis and Psoriatic Arthritis

Health Writer

Psoriasis and Psoriatic Arthritis are two chronic and often unrelenting, painful conditions.  A new tool to treat these diseases and their associated symptoms, when they’re associated with excess weight, has just been added to the menu of treatment options.

People who suffer with psoriasis know that the disease can be disfiguring, uncomfortable and very difficult to treat.  Their lifetime can be filled with remissions and flare-ups.  The current arsenal of medications can help to limit the disease in some, but overall once diagnosed, many individuals will suffer with both psoriasis and psoriatic arthritis for the rest of their lives.

Some fast factsFor those who aren't as well-versed in the condition, psoriasis is a chronic and sometimes painful skin disease marked by red, itchy, scaly patches.  These skin symptoms can be unpredictable and the** most common areas infected include knees, elbows, scalp, as well as other areas of the torso including palms and feet.**  The loose, silvery colored plaques and red skin can be itchy and painful, and they can crack and bleed.

Psoriasis can sometimes be associated with psoriatic arthritis, which involves pain and swelling in the joints.  It’s estimated that between 10-30 percent of individuals with psoriasis also have psoriatic arthritis.

  • Anyone can get psoriasis but it’s typically an adult skin condition.

  • Often, there’s a family history of the disease.

  • Both men and women have similar rates of psoriasis.

  • Infections, stress, weather changes and certain medications can make the psoriasis worse.

  • Current treatments need to be individualized and include topical creams, light therapy, systemic biological injections and combinations of these therapy options.

  • Keeping skin moist can help to reduce flare-ups.

The study

Researchers reviewed the medical charts of 9,073 patients who had undergone weight loss surgery between 2002 and 2013 at NYU Langone’s Weight Management Program.  They focused on 86 patients who had psoriasis before surgery.  Of those 86 patients, 21 also had psoriatic arthritis.  The researchers compared symptoms before and after bariatric surgery.

On average, these patients lost 46. percent of their body weight during six years of monitoring.  Researchers noted that 55 percent of patients with psoriasis and 62 percent of patients with psoriatic arthritis reported significant improvements in their conditions after surgery.  Using severity scores to rate the symptoms before and after surgery, the researchers observed that the scores dropped significantly after surgery, with decreasing scores indicating decreasing symptoms and suffering.  It was also observed that the greater the weight loss in the first year, the more dramatic the improvement in symptoms of psoriasis and psoriatic arthritis.

Other findings from the study

  • Losing excess weight can improve symptoms in people with lifelong chronic conditions.
  • Excess weight loss may help to reduce body-wide inflammation and pain triggered by extreme excesses of fat tissue
  • Patients with obesity who shed significant weight and have comorbid conditions such as psoriasis and psoriatic arthritis could see significant symptomatic relief.
  • The study clearly showcases the benefits of collaboration between rheumatology and bariatric surgery researchers to help patients directly, and inform the medical community about links between diseases and treatments that can provide multiple benefits, in this case weight loss, and improvement in a skin disorder and a specific arthritic disorder.

Sources:

Clinical Improvements in Psoriasis and Psoriatic Arthritis with Surgical Weight Loss

Newswise

Medpage

National Institute of Arthritis and Musculoskeletal and Skin Diseases

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