Obesity‐induced immunological effects on the skin

Abstract

There is an increasing prevalence of obesity globally. Equally, the significance of maintaining a healthy body weight for maintaining a healthy skin homoeostasis is gaining greater attention. On this background, there is growing evidence of an adverse influence of excess body weight on the immune system, which has a resultant detrimental effect on the functioning of the skin. The presence of obesity appears to intensify various inflammatory skin disorders. These immune‐dermatological consequences in the obese occur because of multiple adverse changes in the skin physiology, endocrine imbalance, metabolic deviations, alterations in circulation, skin microbiome and immunological disruptions. The purpose of this article is to highlight the profound impact of increased fat deposition on cutaneous immunology and its role in the pathophysiology of various chronic inflammatory dermatological conditions. Understanding these immunological modulations will aid in developing therapies targeting the specific inflammatory mediators in the management of obesity‐associated chronic immunological skin disease.

Proopiomelanocortin (POMC) and psychodermatology

“…A recent systematic review has shown a correlation between excess weight gain in psoriasis and worsening psychosocial outcomes 52 . This is perhaps not surprising and fits with the previous discussions about obesity, depression and HPA function 3,12,19–27,29,30,32–34,43,50,51 …”

“…52 This is perhaps not surprising and fits with the previous discussions about obesity, depression and HPA function. 3,12,[19][20][21][22][23][24][25][26][27]29,30,[32][33][34]43,50,51 There are wide variations in clinical outcomes in psoriasis. 53 In a cluster analysis of health literacy, a significant subgroup had lower psoriasis knowledge, quality of life, ability to self-manage and feelings of worth.…”

“…Simple obesity is extremely common 21 and has many associations with skin diseases, 32 , 33 many of which have an immunological pathogenesis (Table 2 ). 34 Obesity in itself is frequently associated with psychiatric disease and disruption of the POMC system may play a part in the psychiatric components, whether obesity is present or not. 35 , 36 , 37 It seems reasonable to assume that either acute or chronic stress might be associated with flares of skin disease, 1 , 2 , 3 , 10 either through direct neuroendocrine effects, 1 , 2 , 3 , 10 epigenetic effects 38 or through effects on the cutaneous immune system and microbiome.…”

“… 35 , 36 , 37 It seems reasonable to assume that either acute or chronic stress might be associated with flares of skin disease, 1 , 2 , 3 , 10 either through direct neuroendocrine effects, 1 , 2 , 3 , 10 epigenetic effects 38 or through effects on the cutaneous immune system and microbiome. 4 , 10 , 28 , 34 , 38 …”

“… 52 This is perhaps not surprising and fits with the previous discussions about obesity, depression and HPA function. 3 , 12 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 29 , 30 , 32 , 33 , 34 , 43 , 50 , 51 …”