Obesity is an important factor in the development and progression of a number of dermatological diseases, such as psoriasis, follicular occlusion syndrome, in particular hidradenitis suppurativa and acne, atopic dermatitis, bacterial and fungal skin lesions, conditions that are manifestations of insulin resistance, as well as chronic venous insufficiency and lymphedema. In obesity, adipose tissue becomes a source of pro-inflammatory M1 macrophages, pro-inflammatory cytokines (TNFα, IL-1β, 6), which ensure the formation of inflammation and dysregulation of adipokines — an increase in the level of pro-inflammatory adipokines, among which leptin is the key one, and a decrease in the level of adiponectin, which has anti-inflammatory activity. In addition, obesity is associated with impaired remodeling of the extracellular matrix leading to fibrosis and impaired barrier function of the skin. All this causes subclinical chronic inflammation in the body of obese patients, which is the basis for the development of dermatoses. Pharmaceutical products used in dermatology may contribute to an increased risk of non-alcoholic fatty liver disease, hyperglycemia, hyperlipidemia and arterial hypertension in such patients. Obese patients may require higher doses of drugs, which is associated with an increased incidence of side effects. In 2021, the FDA approved semaglutide for the treatment of patients with obesity. Several studies have demonstrated improvement in symptoms of hidradenitis suppurativa and psoriasis in presence of semaglutide application, but data on its side effects on the skin, including an increased risk of alopecia, are already accumulating. Thus, obesity contributes to the development of dermatological diseases that require a special treatment approach considering the risk of drug side effects in this group of patients.
Eremina et al. (Fri,) studied this question.