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Psoriasis

Lifestyle modifications

NUTRITION

  • Obesity tends to worsen the condition. A hypocaloric diet may improve symptoms in overweight and obese individuals (BMI > 25)  (1). Compared to usual care, dietary intervention (strict caloric restriction) may lead to 75% or greater improvement from baseline (large uncertainty) in the Psoriasis Area and Severity Index (PASI 75) (2).

  • Alcohol: There is some/mixed evidence that alcohol may increase symptoms of psoriasis, but more studies are needed to determine whether alcohol can induce or worsen psoriasis (7,6,5,4,3)

  • Omega 3: Some evidence that it may improve symptoms alone, or in combination with standard treatment (10)


PHYSICAL ACTIVITY

  • Vigorous physical activity is associated with reduced risk of psoriasis (12)

  • More research is needed to determine whether physical activity may reduce symptoms (13)


SMOKING

  • Smoking is a risk factor for psoriasis (3, 4)


STRESS

  • There is mixed/weak evidence that preceeding psychological stress is associated with psoriasis exacerbation/onset (8,9)


SUNLIGHT

  • Exposure to natural sunlight and salt water bath improve the condition (1)


LIFESTYLE PREVENTION OF COMORBIDITIES

  • Psoriasis increases the risk of cardiovascular disease and diabetes type 2. Discuss cardiovascular risk factors with psoriasis patients, including hyperlipidemia, hypertension, smoking, alcohol use disorder, physical activity and diabetes type 2 prevention (11).

References

Resources

Evidence Pyramid

EXPLANATION TO EVIDENCE PRESENTATION

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Evidence based on guidelines and evidence based Clinical Decision Systems is written in BOLD

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Evidence based on meta analysis or systematic reviews is written in BOLD and CURSIVE

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Evidence based on randomized controlled trials is written in plain font

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Evidence based on observational / cohort studies is written in CURSIVE

Figure: Evidence pyramid

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