Skin manifestations after bariatric surgery

Abstract

Background Skin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS). Data concerning the skin findings exclusively in post-BaS patients remain limited. Methods Seventy post-BaS patients were examined for cutaneous abnormalities. The patients were divided into those with successful weight loss (% excessive body weight loss (EBWL) of at least 50%) and a non-successful group (%EBWL < 50%). Results Forty-six patients with successful weight loss demonstrated a significantly lower prevalence of acanthosis nigricans on the neck, axillae and inguinal areas, keratosis pilaris (KP) and pebble fingers. However, a higher prevalence of alopecia was observed. After adjustment with patients’ factors, KP (adjusted odds ratio (aOR) = 0.21, 95%CI 0.06–0.74, p = 0.02) and pebble fingers (aOR = 0.09, 95%CI 0.01–0.89, p = 0.04) remained significantly less likely in patients with successful weight loss. Laboratory results comparing pre- and post-surgery values revealed significant decreases in fasting plasma glucose, hemoglobin A1c, and triglyceride and an increase of high-density lipoproteins in both groups. However, significant decreases of liver aminotransferases (AST and ALT) were observed only in the successful group (p = 0.04, 0.003). Nonetheless, a decrease in vitamin B12 (p = 0.01) was observed in the successful group. Conclusion Weight loss after BaS provided an improvement for metabolic profiles. Successful weight reduction resulted in better skin improvement. However, nutritional supplements may be necessary. Trial registration Thai Clinical Trials Registry TCTR20171003002. Registered October 3. 2017, retrospectively registered.

Cutaneous manifestations of obesity in Turkish children: A comparative study

“…24 Obesityassociated AN may show clinical improvement with weight loss. [25][26][27][28] Our study demonstrated that AN in children with obesity was most frequently located on the neck, a visible area not normally covered with clothing. In light of these findings, we think it important to inform the child and family that AN will improve with weight loss.…”

“…In addition to its association with insulin resistance, the appearance of AN may cause psychological distress for the child and the family, including stigmatizing behaviors such as changing dress style to cover up AN 24 . Obesity‐associated AN may show clinical improvement with weight loss 25–28 . Our study demonstrated that AN in children with obesity was most frequently located on the neck, a visible area not normally covered with clothing.…”

The Link Between Obesity and the Skin

“…Zinc deficiency resulting from malabsorption in bariatric surgery has been linked to the development of the rare condition known as necrotic migratory erythema ( 74 ). Despite the clinical improvement of acanthosis nigricans, the development of alopecia has been described in a cohort of post bariatric surgery in relation to malabsorption ( 75 ). In post-bariatric abdominoplasty, delayed wound healing, skin infections, and umbilical necrosis have been shown to be significantly correlated with certain predictors such as initial BMI, type 2 diabetes, tobacco smoking, and the amount and timing of abdominoplasty ( 76 ).…”

Acanthosis Nigricans: Pointer of Endocrine Entities

“…In terms of AN management, the treatment of the underlying disease represents a stepping stone in improving AN: nutritional and psychological intervention for weight control; bariatric surgery; insulin sensitizers for IR, usually metformin; oral contraceptives in PCOS; or gonadotropin releasing hormone agonist therapy in young populations for hyperandrogenemia [ 48 , 49 , 50 ]. There are also dermatological options (which are not typically used in every day practice), such as topical retinoids or vitamin D analogues, chemical peels (trichloroacetic acid or salicylic–mandelic acid peeling), alexandrite laser, and systemic retinoids [ 28 , 29 , 37 , 51 ].…”