Obesity and Skin Diseases

A. Obesity is defined as a medical condition of excess body fat has accumulated overtime, while overweight is a condition of excess body weight relatively to the height. According to the Body Mass Index(BMI), a BMI between 25 to 29.9 is considered over weight, while a BMI of over 30 is an indication of obesity. According to the statistic, 68% of American population are either overweight or obese.

B. Skin infection is defined as a condition of infection of skin caused by certain bacteria, including Impetigo (a highly contagious bacterial skin infection), Erysipelas (an acute streptococcus bacterial infection), Cellulitis (a diffuse inflammation, etc. ,fungal skin infections of the skin, hair, and/or nails, parasitic infestations and viral related infections

C. How do calculate your BMI index
BMI= weight (kg)/ height (m2)

D. How Obesity associates with Skin Diseases
1. According to the study of "Skin manifestations of obesity: a comparative study" by Boza JC, Trindade EN, Peruzzo J, Sachett L, Rech L, Cestari TF. (Source from Department of Dermatology, Federal University of Rio Grande do Sul (UFRGS), Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, Brazil, © 2011 The Authors. Journal of the European Academy of Dermatology and Venereology © 2011 European Academy of Dermatology and Venereology), posted in PubMed, researchers concluded that Obesity is strongly related to several skin alterations that could be considered as markers of excessive weight. Skin care of obese patients deserves particular attention, not only because of the high prevalence of cutaneous alteration but mainly because many of these disorders are preventable and could be treated, improving patient's quality of life.

2. In the abstract of the study of " The impact of obesity on skin disease and epidermal permeability barrier status" by Guida B, Nino M, Perrino NR, Laccetti R, Trio R, Labella S, Balato N. (Source from Department of Neuroscience, Physiology Nutrition Unit, University Federico II, Naples, Italy. bguida@unina.it, J Eur Acad Dermatol Venereol. 2010 Feb;24(2):191-5. Epub 2009 Nov 19), posted in PubMed. researchers found that Specific dermatoses as skin tags, striae distensae and plantar hyperkeratosis, could be considered as a cutaneous stigma of severe obesity. The low permeability of the skin to evaporative water loss is observed in obese subjects compared with normal weight control. Although the physiological mechanisms are still unknown, this finding has not been previously described and we believe that this may constitute a new field in the research on obesity.

3. In a study of "The influence of body mass index on skin susceptibility to sodium lauryl sulphate" by Löffler H, Aramaki JU, Effendy I. (Source from Department of Dermatology, University of Marburg, Germany. Harald.Loeffler@mailer.uni-marburg.de, Skin Res Technol. 2002 Feb;8(1):19-22.), posted in PubMed, researchers indicated that Basal biophysical parameters of the skin are primarily correlated with the BMI. This may be caused by obesity-induced physiological changes, e.g. increased sweat gland activity, high blood pressure and physiological temperature-regulating system. The epidermal barrier function, as evaluated after SLS patch testing is, however, not correlated with a high BMI, indicating a normal skin barrier.

4. In a study of "An overview of dermatological conditions commonly associated with the obese patient" by Hahler B. (Source from St. Vincent Mercy Medical Center, 2213 Cherry Street, Toledo, OH 43608, USA. hahlb@buckeye-access.com, Ostomy Wound Manage. 2006 Jun;52(6):34-6, 38, 40 passim), posted in PubMed, researchers found that with the continuing increase in the incidence of obesity, investigation into the specific care needs of this population is needed. In clinical practice, measures to reduce friction and shear and improve devices to move the obese patient would enhance care provision. Studies of the incidence of dermatological problems and the best treatments for these conditions are warranted.

5. Etc.

E. Treatments of Obesity and Skin Diseases
1. In a study of "[Skin manifestations, treatment and rehabilitation in overweight and obesity].

[Article in Hungarian] by Wenczl E. (Source from Fovárosi Onkormányzat Egyesített Szent István és Szent László Kórház és Rendelointézet Borgyógyászati és Lymphológiai Rehabilitációs Osztály Budapest Nagyvárad tér 1. 1095, Orv Hetil. 2009 Sep 13;150(37):1731-8), researchers found that 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.

2. According to the study of "Dermatological complications of obesity" by García Hidalgo L. (Source from Department of Dermatology, Salvador Zubiran National Nutrition Institute, Mexico City, Mexico. lindagh@avantel.net, Am J Clin Dermatol. 2002;3(7):497-506.), posted in PubMed, researchers found that Excess load on the feet can result in morphological changes that require careful diagnosis; insoles may offer some symptom relief while control of obesity is achieved. Obesity-related dermatoses associated with hospitalization, such as pressure ulcers, diminished wound healing, dermatoses secondary to respiratory conditions, and incontinence, must all be carefully managed with an emphasis on prevention where possible. Recognition and control of the dermatological complications of obesity play an important role in diminishing the morbidity of obesity.

3. In an abstract of the studt of "Obesity and the skin: skin physiology and skin manifestations of obesity" by Yosipovitch G, DeVore A, Dawn A. (Source from Departments of Dermatology, Regenerative Medicine, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA. gyosipov@wfubmc.edu, J Am Acad Dermatol. 2007 Jun;56(6):901-16; quiz 917-20.) posyed in PubMed, researchers indicated that evidence for association with obesity, and management of these various dermatoses and highlight the profound impact of obesity in clinical dermatology. LEARNING OBJECTIVE: After completing this learning activity, participants should be aware of obesity-associated changes in skin physiology, skin manifestations of obesity, and dermatologic diseases aggravated by obesity, and be able to formulate a pathophysiology-based treatment strategy for obesity-associated dermatoses.

4. Etc.

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