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    Skin presentations common in obese patients

    Chronic conditions like psoriasis worsen with obesity; bariatric skin heals poorly

    Obesity is a public health epidemic associated with cardiovascular disease, stroke, and diabetes, but the presence of obesity is also linked to numerous dermatological presentations related to the increased amount of skin and to the pathophysiology of obesity.

    "Obesity can lead to skin tags," explains Benjamin Barankin M.D., F.R.C.P.C., a dermatologist based in Toronto, Ontario, Canada and Co-Founder of the Toronto Dermatology Centre. "People who are obese have more skin tags, in more areas, and they are bigger skin tags. Stretch marks also appear more often in obese individuals."

    RELATED: Obese children present with more inflammatory conditions

    Dr. Barankin notes another condition linked to obesity is acanthosis nigricans, a thickening and darkening of the skin in sites like the armpits, groin, neck and other intertriginous areas. General thickening of the skin and darkening of the elbows and knees is common in larger patients compared to patients of normal weight, Dr. Barankin adds.

    Infections, both bacterial and fungal, are also more common in obese than non-obese patients, he says.

    Patient counseling

    A condition like hidradenitis suppurativa is associated with the carriage of excess weight, as is chronic plaque psoriasis, and shedding excess weight is associated with improvements in those conditions, a point that creates an opportunity for dermatologists to communicate with their patients about how they can influence their disease course through their diet and activity, Dr. Barankin explains.

    RELATED: Disgruntled patients require access, attention

    "We are always looking for reasons for people to adopt healthy lifestyle choices and behaviours," Dr. Barankin says, stressing obesity exacerbates psoriasis. "If a patient is bothered by his or her psoriasis, here is another reason to take steps like see a dietician, lose weight, and exercise more."

    NEXT: Obesity, psoriasis link

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