Skin manifestations, treatment and rehabilitation in overweight and obesity

Abstract

Overweight and obesity is a public health problem in Hungary and in the Western world. It is important to underline that obesity is an illness and an important risk factor for several skin and other diseases. An overview of skin diseases caused or aggravated by obesity (acanthosis nigricans, acrochordons, keratosis pilaris, hyperandrogenism, stria, adiposis dolorosa, lymphoedema, chronic venous insufficiency, plantar hyperkeratosis, lipoedema, skin infections, acne inversa, psoriasis, tophi) helps us to look and see as well. Look for the possibility of skin infections as it helps the early diagnosis and to avoid complications. Draw patients' attention to the preventive importance of skin care. In case of an obese patient the usual dosage of most local and systemic drugs should be modified. It must be kept in mind that obesity directly or indirectly starts unfavorable processes in almost all organ systems. Therefore, only a multidisciplinary care may secure treatment and rehabilitation of obese patients. Dermatological and lymphological care is often part of the rehabilitation.

Skin manifestations after bariatric surgery

“…The result of our study also demonstrates that in patients who achieved successful weight loss, the prevalence of KP and pebble finger is lower. The correlation of AN, KP and pebble fingers with insulin resistance and hyperinsulinemia is well established [3,5,7]. Diet control that leads to weight reduction can improve insulin resistance status and lessen AN severity [23].…”

“…Skin signs associated with obesity may be divided into those that occur as a result of insulin resistance such as acanthosis nigricans (AN) [2][3][4] acrochordons [3,4], and keratosis pilaris (KP) [3][4][5]. Additionally, mechanical effects may give rise to plantar hyperkeratosis, striae distensae, adiposis dolorosa, and chronic venous insufficiency [3,4].…”

Dermatological aspects influencing the practice of physical activities by obese individuals

“…This condition affects both healthy and obese individuals and is usually associated with acanthosis nigricans, endocrine diseases or personal characteristics of unknown etiology. Friction, rubbing and trauma due to sport, as well as scratching, can cause inflammation of the lesions and changes in color and size, and need to be examined by a physician in order to be differentiated from other dermatoses (1,2,29,31,36,37,43,58).…”

“…However, proper exercise prescription helps improve body image, encourages socialization and long-term adherence to exercise and may help gradually increase positive attitudes toward weight control and health care (36).…”

“…Studies have shown that skin disorders in obese individuals can vary in severity, prevalence and response to treatment. They are caused by changes in the skin surface pattern (keratosis pilaris, stretch marks, xanthomas, acrochordons, gynecomastia) (2,(29)(30)(31); hyperandrogenism and hyperinsulinemia (acanthosis nigricans, acne, hirsutism, androgenetic alopecia) (20,(32)(33)(34)(35); increased prevalence of infection (candidiasis, dermatophytosis, folliculitis, furuncles, erythrasma, erysipelas, cellulitis, necrotizing fasciitis) (14,(36)(37)(38); decreased venous return (chronic venous insufficiency, lymphedema, stasis dermatitis and delayed healing of wounds) (13,36). They are also associated with the occurrence of ingrown toenails, keratodermas and calluses on the feet (14,25); and worsening in the severity of psoriasis (39)(40)(41)(42), seborrhea (43)(44) and diabetes symptoms (4,23,35,45).…”