title: Very low-calorie ketogenic diet may allow restoring response to systemic therapy in relapsing plaque psoriasis.
abstract: Psoriasis is a chronic disease associated with overweight/obesity and related cardiometabolic complications. The link between these diseases is likely the inflammatory background associated with adipose tissue, particularly the visceral one. Accordingly, previous studies have demonstrated that in the long-term weight loss may improve the response to systemic therapies. We report a case report of a woman in her 40s suffering from relapsing moderate-to-severe plaque psoriasis and obesity-related metabolic syndrome, in whom adequate response to ongoing treatment with biological therapy (adalimumab) was restored after only 4 weeks of very low-calorie, carbohydrate-free (ketogenic), protein-based diet. Accordingly, through rapid and consistent weight loss, very low calorie ketogenic diet may allow restoring a quick response to systemic therapy in a patient suffering from relapsing psoriasis. This intervention should be considered in overweight/obese patients before the rearrangement of systemic therapy. Nonetheless, studies are required to evaluate whether very low calorie ketogenic diets should be preferred to common low-calorie diets to improve the response to systemic therapy at least in patients with moderate-to-severe psoriasis.
authors.affiliation: Clinical Nutrition Unit - A.O.R.N. "San Giuseppe Moscati", Avellino, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Castaldo
authors.affiliation: Dermatology and Dermatosurgery Unit - A.O.R.N. "San Giuseppe Moscati", Avellino, Italy.
authors.forename: Giovanna
authors.initials: G
authors.lastname: Galdo
authors.affiliation: Dermatology and Dermatosurgery Unit - A.O.R.N. "San Giuseppe Moscati", Avellino, Italy.
authors.forename: Felice
authors.initials: F
authors.lastname: Rotondi Aufiero
authors.affiliation: Nutrition and Dietetics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy. Electronic address: e.cereda@smatteo.pv.it.
authors.forename: Emanuele
authors.initials: E
authors.lastname: Cereda
mesh_terms: D000068879:Adalimumab / Q000627:therapeutic use*; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use; D031204:Caloric Restriction; D050528:Diet, Carbohydrate-Restricted; D055423:Diet, Ketogenic; D004038:Diet, Reducing; D002149:Energy Intake; D005260:Female; D006801:Humans; D024821:Metabolic Syndrome / Q000150:complications; D009765:Obesity / Q000150:complications / Q000178:diet therapy*; D011565:Psoriasis / Q000188:drug therapy* / Q000209:etiology; D012008:Recurrence; D015431:Weight Loss / Q000502:physiology*
chemical_list: D000893:Anti-Inflammatory Agents; D000068879:Adalimumab
keywords: Ketogenic diet; Plaque psoriasis; Very low-calorie diet; Weight loss