Psoriasis Recap: Intermittent Fasting, Microbiome-Skin Links, and More

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Updates from 2 recent medical meetings about links between the gut, psoriasis, and other skin disease, as well as the risk of COVID-19.

According to recent research presented at the recent European Academy of Dermatology and Venerology (EADV) 2021 Spring Symposium, modified intermittent fasting may benefit patients with psoriasis.

Dermatology Times reported, the study aimed to determine if there is a link between gut health and psoriatic lesions, as well as learn of any benefits of modified intermittent fasting in managing psoriasis. Modified intermittent fasting was defined as eating normally for 5 days and restricting calorie intake for 2 nonconsecutive days.

A total of 24 patients were enrolled; 12 were told to modify their diet and the other 12 ate normally. The fasting group ate 500 kcal twice per week on 2 nonconsecutive days, but on all other days were free to eat like usual. After the trial started, 2 patients were excluded, 1 for antibiotic use and the other for loss of follow up.

The Psoriasis Area and Severity Index score and Body Surface Area score was similar between both arms at week 0. At week 6 and week 12, the fasting group reported significant skin improvement, including less scaling and skin thickening, and 30% of patients saw a decrease in itching.

According to another EADV presentation reported by Dermatology Times, an imbalance in gut microbiota bacteria could play a significant role in the progression of hidradenitis suppurativa (HS), an inflammatory skin disease.

Researchers examined fecal samples from 15 patients. The samples were analyzed for regions of bacterial 16S ribosomal ribonucleic acid gene to investigate differences in their gut microbiota.

The relative abundance of 3 genera of bacteria—unclassified Clostridiales, unclassified Firmicutes, and Fusicatenibacter—were significantly lower in patients with HS than the control group. Lower amounts of these bacteria are known to disrupt the regulatory balance within the gut and stimulate an inflammatory response.

It is already known that the gut-skin axis is linked to multiple inflammatory and autoimmune skin diseases, such as acne and psoriasis.

Lastly, patients with psoriasis appear more likely to contract COVID-19, according to recent research presented at the American Academy of Dermatology Virtual Meeting Experience 2021. A presentation at the meeting examined the link between systemic treatments and COVID-19 infection risk in patients with psoriasis, compared with the general population.

According to Dermatology Times, researchers used a pharmacy claims database to assess the risk of COVID-19 infection in patients treated with systemic therapies compared with those treated with topical therapies.

More than one-third of patients with psoriasis had COVID-19 compared with the general population. Tumor necrosis factor α inhibitor correlated with a 18% reduction in COVID-19 incidence compared with those using topicals and 17% versus controls. Methotrexate was linked with a 25% reduction in COVID-19 infection, and apremilast had a 31% reduction when compared with those using topicals.

Interleukin-17 inhibitors were linked with a 36% increase in COVID-19 incidence versus 51% in those taking oral therapies. For patients prescribed ustekinumab, there was a 37% increase versus controls.