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Children with psoriasis more likely to be obese

Children with psoriasis are at significantly greater risk of being overweight, according to a study by the Northwestern University School of Medicine. In the United States, children with severe psoriasis were more likely to be obese.

The study, published Nov. 19 on the Archives of Dermatology website, examined 409 children with psoriasis from nine countries. Nearly 40 percent of the children were overweight. Among children from the United States with severe psoriasis, 34 percent had a body mass index, or BMI, classified as obese.

The study's findings could have several implications, said. Dr. Amy S. Paller, chair of Northwestern University’s dermatology department and co-author of the study. "I think what these findings mean is that we need to start paying attention not just to the skin lesions themselves," she said. "We need to recognize that psoriasis, just as with an adult, is in the spectrum of metabolic issues associated with (being) overweight or obese, and that may be even more closely associated with children and psoriasis."

Previous studies have linked psoriasis with an increased risk in adults for type 2 diabetes, cardiovascular disease, Crohn’s disease and other comorbidities. Dermatologists with pediatric psoriasis patients also should check height and weight, measure blood pressure and screen for those other diseases, particularly in overweight and obese patients, Paller said.

It also means that health care providers should treat psoriasis in children early on and that particularly in children who are overweight or obese, doctors and parents should work together to encourage healthy diet and exercise habits, Paller said.

"Until the teen years, parents do have a fair amount of control over healthy food and healthy living," Paller said.

Researchers noted that children with severe psoriasis were more likely to carry excess weight around their mid-section, measured by comparing waist circumference with height.

The cause-and-effect relationship between psoriasis and excess weight is unclear. Not all people with psoriasis or psoriatic arthritis are overweight or obese, Paller said.

While there are no data to support it, the study gives fuel to the idea that if parents and health care providers can stymie excess weight in a child with psoriasis early on, it could improve outcomes, Paller said.

Long-term studies are needed to see if controlling weight over time can prevent psoriasis or lessen the severity of psoriasis, she said.

Learn more about the importance of good nutrition and exercise for kids.

Listen to Paller’s interview about the childhood obesity and psoriasis study.

December 4, 2012

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