title: Environmental Risk Factors in Psoriasis: The Point of View of the Nutritionist.
abstract: Psoriasis is a common, chronic, immune-mediated skin disease with systemic pro-inflammatory activation, where both environmental and genetic factors contribute to its pathogenesis. Among the risk factors for psoriasis, evidence is accumulating that nutrition plays a major role, per se, in psoriasis pathogenesis. In particular, body weight, nutrition, and diet may exacerbate the clinical manifestations, or even trigger the disease. Understanding the epidemiological relationship between obesity and psoriasis is also important for delineating the risk profile for the obesity-related comorbidities commonly found among psoriatic patients. Moreover, obesity can affect both drug's pharmacokinetics and pharmacodynamics. Additionally, the overall beneficial effects on the obesity-associated comorbidities, clinical recommendations to reduce weight and to adopt a healthy lifestyle could improve the psoriasis severity, particularly in those patients with moderate to severe disease, thus exerting additional therapeutic effects in the conventional treatment in obese patients with psoriasis. Education regarding modifiable environmental factors is essential in the treatment of this disease and represents one of the primary interventions that can affect the prognosis of patients with psoriasis. The goal is to make psoriatic patients and health care providers aware of beneficial dietary interventions. The aim of this review is to assess the relevance of the environmental factors as modifiable risk factors in psoriasis pathogenesis, with particular regard to the involvement of obesity and nutrition in the management of psoriasis, providing also specific nutrition recommendations.
authors.affiliation: I.O.S. &amp; COLEMAN Srl, 80011 Naples, Italy. luigi.barrea@unina.it.
authors.forename: Luigi
authors.initials: L
authors.lastname: Barrea
authors.affiliation: I.O.S. &amp; COLEMAN Srl, 80011 Naples, Italy. dott.ssa.nappi@gmail.com.
authors.forename: Francesca
authors.initials: F
authors.lastname: Nappi
authors.affiliation: IRCCS SDN, Napoli Via Gianturco 113, 80143 Naples, Italy. cdisomma@unina.it.
authors.forename: Carolina
authors.initials: C
authors.lastname: Di Somma
authors.affiliation: I.O.S. &amp; COLEMAN Srl, 80011 Naples, Italy. cristysav@hotmail.com.
authors.forename: Maria Cristina
authors.initials: MC
authors.lastname: Savanelli
authors.affiliation: I.O.S. &amp; COLEMAN Srl, 80011 Naples, Italy. falco.and@gmail.com.
authors.forename: Andrea
authors.initials: A
authors.lastname: Falco
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy. anna.balato@unina.it.
authors.forename: Anna
authors.initials: A
authors.lastname: Balato
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Unit of Dermatology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy. nicola.balato@unina.it.
authors.forename: Nicola
authors.initials: N
authors.lastname: Balato
authors.affiliation: Dipartimento di Medicina Clinica e Chirurgia, Unit of Endocrinology, Federico II University Medical School of Naples, Via Sergio Pansini 5, 80131 Naples, Italy. sisavast@unina.it.
authors.forename: Silvia
authors.initials: S
authors.lastname: Savastano
mesh_terms: D015897:Comorbidity; D004032:Diet; D006801:Humans; D009752:Nutritional Status; D064686:Nutritionists; D009765:Obesity / Q000453:epidemiology; D011565:Psoriasis / Q000453:epidemiology*; D012307:Risk Factors
keywords: Mediterranean diet; bioelectrical impedance analysis; body composition; environmental risk factors; lifestyle; nutrition; nutritionist; obesity; phase angle