Cutaneous manifestations in obese patients and non-obese controls in a tertiary care centre: a case-control study
DOI:
https://doi.org/10.18203/issn.2455-4529.IntJResDermatol20194633Keywords:
Obesity, Acanthosis nigricans, Acrochordons, Body mass indexAbstract
Background: Obesity has emerged as one of the most serious public health concerns in the 21st century. It is responsible for varied changes in structure and function of different components of skin. Skin care of obese patients deserves particular attention, not only because of high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient’s quality of life.
Methods: Two hundred patients with BMI ≥30 kg/m2 and two hundred age and sex matched controls (BMI: 18.5-24.9 kg/m2) were included in this study.
Results: Compared to the control group, obese patients were having higher prevalence of various skin conditions of which most common were acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections.
Conclusions: There is increased incidence and severity of cutaneous manifestations like acanthosis nigricans, acrochordons, striae distensae, frictional hyperpigmentation and infections in obese patients than control subjects. These can be used as markers for the early detection of various components of metabolic syndrome.
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References
McGibbon DH. Subcutaneous fat. In: Burns T, Breathnach S, Cox N, Griffiths C, editors. Rook’s Textbook of Dermatology 8th ed. Oxford: Blackwell science; 2010: 46.
World Health Organisation. Obesity and overweight fact sheet # 311. Available at: http://www.who.int/ mediacentre/factsheets/fs311/en/index.html. Accessed on 3 February 2018.
Kalra S, Unnikrishnan AG. Obesity in India: The weight of the nation. J Med Nutr Nutracent. 2012;1:37-41.
Gupta V. Obesity. JK-Practitioner. 2004;11:210-6.
Loffler H, Aramaki JU, Effendy I. The influence of body mass index on skin susceptibility to sodium lauryl sulphate. Skin Res Technol. 2002;8:19-22.
Yosipovitch G, Dovore A. Obesity and skin: Skin physiology and skin manifestations of obesity. J Am Acad Dermatol. 2007;56(6):901-16.
Deplewski D, Rosenfield RL. Growth hormone and insulin-like growth factors have different effects on sebaceous cell growth and differentiation. Endocrinology. 1999;140:4089-94.
Cappel M, Mauger D, Thiboutot D. Correlation between serum levels of insulin-like growth factor 1, dehydroepiandrosterone sulfate, and dihydrotestosterone and acne lesion counts in adult women. Arch Dermatol. 2005;141:333-8.
Goodson WH III, Hunt TK. Wound collagen accumulation in obese hyperglycemic mice. Diabetes. 1986;35:491-5.
Eknoyan G. Adolphe Quetelet (1796-1874)—the average man and indices of obesity. Nephrol Dial Transplant. 2008;23:47-51.
Park K. Park’s Textbook of Preventive and Social Medicine. 22nd ed. Jabalpur, India: Banarsidas Bhanot publishers; 2013: 367-368.
Park K. Park’s Textbook of Preventive and Social Medicine. 22nd ed. Jabalpur, India: Banarsidas Bhanot Publishers; 2013.
Boza JC, Trindade EN, Peruzzo J, Sachett L, Rech L, Cestari TF. Skin manifestations of obesity: a comparative study. J Eur Acad Dermatol Venereol. 2012;26:1220-3.
Al-Mutairi N. Associated cutaneous diseases in obese adult patients: a prospective study from a skin referral care center. Med Princ Pract. 2011;20:248-52.
Szczygielska A, Widomska S, Jaraszkiewicz M, Knera P, Muc K. Blood lipids profile in obese or overweight patients. Ann Univ Mariae Curie Sklodowska Med. 2003;58:343-9.
Bhatti MS, Akbri MZ, Shakoor M. Lipid profile in obesity. J Ayub Med Coll Abbottabad. 2001;13:31-3.
Khan SB, Hafiz-ur-Rehman, Noor L, Hameedullah, Hafeezullah M, Gul AM, et. al. Prevalence of diabetes mellitus among obese and non-obese patients with coronary artery disease. J Ayub Med Coll Abbottabad. 2010;22:64-7.
Khunti K. Metabolic syndrome. BMJ. 2005;331:1153.
Hud JA Jr, Cohen JB, Wagner JM, Cruz PD Jr. Prevalence and significance of acanthosis nigricans in an adult obese population. Arch Dermatol. 1992;128:941-4.
Katz AS, Goff DC, Feldman SR. Acanthosis nigricans in obese patients: Presentations and implications for prevention of atherosclerotic vascular disease. Dermatol Online J. 2000;6:1.
Burke JP, Hale DE, Hazuda HP, Stern MP. A quantitative scale of acanthosis nigricans. Diabetes Care. 1999;22:1655-9.
Garcia-Hidalgo L, Orozco-Topete R, Gonzalez-Barranco J, Villa AR, Dalman JJ, Ortiz-Pedroza G. Dermatoses in 156 obese adults. Obes Res. 1999;7:299-302.
Lecerf JM, Reitz C, de Chasteigner A. Evaluation of discomfort and complications in a population of 18,102 overweight or obese patients [Article in French with English abstract]. Presse Med. 2003;32:689-95.
Garcia-Hidalgo L. Dermatological complications of obesity. Am J Clin Dermatol. 2002;3:497-506.
Spink MJ, Menz HB, Lord SR. Distribution and correlates of plantar hyperkeratotic lesions in older people. J Foot Ankle Res. 2009;2:8.
Fantuzzi G. Adiponectin in inflammatory and immune-mediated diseases. Cytokine. 2013;64:1-10.
Fleming P, Kraft J, Gulliver WP, Lynde C. The Relationship of Obesity with the severity of Psoriasis: A Systematic Review. J Cutan Med Surg. 2015;19:450-6.
Ganguly S, Ray L, Kuruvila S, Nanda SK, Ravichandran K. Lipid accumulation product index as visceral obesity indicator in psoriasis: A case-control study. Indian J Dermatol. 2018;63:136-40.
Wang Y, Chen J, Zhao Y, Geng L, Song F, Chen HD. Psoriasis is associated with increased levels of serum leptin. Br J Dermatol. 2008;158:1134-5.
Corbetta S, Angioni R, Cattaneo A, Beck-Peccoz P, Spada A. Effects of retinoid therapy on insulin sensitivity, lipid profile and circulating adipocytokines. Eur J Endocrinol. 2006;154:83-6.
Lebwohl M, Callen JP. Obesity, Smoking and Psoriasis. JAMA. 2006;295:208-10.
Imamoglu B, Hayta SB, Ozcelik S. Metabolic syndrome may be an important comorbidity in patients with seborrheic dermatitis. Arch Med Sci Atheroscler Dis. 2016;1:e158-e161.
Halvorsen JA, Vleugels RA, Bjertness E. A population-based study of acne and body mass index in adolescents. Arch Dermatol. 2012;148:131-2.
Abulnaja KO. Oxidant/antioxidant status in obese adolescent females with acne vulgaris. Indian J Dermatol. 2009;54:36-40.
Barth JH, Ng LL, Wojnarowska F, Dawber RP. Acanthosis nigricans, insulin resistance and cutaneous virilism. Br J Dermatol. 1988;118:613-9.
Bhat YJ, Latief I, Hassan I. Update on etiopathogenesis and treatment of acne. Indian J Dermatol Venereol Leprol. 2017;83:298-306.
Silverberg JI, Simpson EL. Association between obesity and eczema prevalence, severity and poorer health in US adolescents. Dermatitis. 2014;25:172-81.
