The long-term impact of bariatric surgery on psoriasis symptoms and severity: a prospective observational study

Abstract

Background: Psoriasis is a common immune-mediated inflammatory skin disease associated with various comorbidities, including obesity.

Objective: This study aimed to investigate changes to psoriasis symptoms, severity, and treatment agents in patients undergoing Metabolic and Bariatric Surgery (MBS).

Setting: Rasool-E Akram University Hospital.

Methods: This prospective observational study consisted of 32 adult patients with obesity and psoriasis who underwent MBS (e.g., Roux-en-Y gastric bypass, One anastomosis gastric bypass, sleeve gastrectomy) between January 2010 and December 2020. Patients with a history of prior MBS were excluded. All patients were examined by a board-certified dermatologist. Psoriasis severity was assessed with the Psoriasis Area and Severity Index (PASI).

Results: The majority of patients were females (n = 29). The mean age of the study population was 46.6 ± 10.8 years, and participants were followed-up for 70.6 ± 29.1 months. A significant decrease in BMI was observed postoperatively from 41.5 ± 4.7 to 30 ± 5.5 kg/m² (P < .001). PASI score significantly decreased from a median (interquartile range [IQR]) of 3.6 (5.90) to 1.20 (3.45) after MBS (P = .006). The number of patients who reported nail involvement significantly decreased following surgery (P = .039), although no significant difference in joint involvement was noted (P = 1.000).

Conclusion: This study shows that MBS can reduce psoriasis severity and lower the number of needed treatments. Given psoriasis's complexity and varied individual responses, personalized treatment is essential. Further research is necessary to validate these findings in a larger population.

Keywords: Bariatric surgery; Obesity; Psoriasis.