Skin changes in the obese patient
Skin changes in the obese patient
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DOI：
10.1016/j.jaad.2018.12.070
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发表时间：
2019-11-01
影响因子：
13.8
通讯作者：
Keri, Jonette E.
中科院分区：
文献类型：
--
作者：
Hirt, Penelope A.;Castillo, David E.;Keri, Jonette E.
肥胖症是一个世界性的重大公共卫生问题，在过去的20年里，肥胖症的患病率以惊人的速度增长。皮肤肥胖的后果被低估了。本文综述了肥胖对皮肤的影响，包括体重指数增加对皮肤生理、皮肤屏障、胶原结构和伤口愈合的影响。肥胖还会影响皮脂腺和汗腺，并导致循环和淋巴系统的变化。与肥胖相关的常见皮肤表现包括黑棘皮病、肩索角化病、毛发角化病、扩张纹、脂肪团和足底角化过度。肥胖会对新陈代谢产生影响，如导致高雄激素血症和痛风，而这又与皮肤症状有关。此外，肥胖与细菌和念珠菌皮肤感染、甲真菌病、炎症性皮肤病以及化脓性汗腺炎、牛皮癣和酒渣鼻等慢性皮肤病的发病率增加有关。在肥胖患者中，特应性皮炎和肥胖与皮肤癌风险增加之间的联系是有争议的。肥胖也与罕见的皮肤病和过早的头发变白有关。作为内科医生，了解这些临床症状和潜在的全身疾病将有助于早期诊断，以便更好地治疗和避免后遗症。
Obesity is a worldwide major public health problem with an alarmingly increasing prevalence over the past 2 decades. The consequences of obesity in the skin are underestimated. In this paper, we review the effect of obesity on the skin, including how increased body mass index affects skin physiology, skin barrier, collagen structure, and wound healing. Obesity also affects sebaceous and sweat glands and causes circulatory and lymphatic changes. Common skin manifestations related to obesity include acanthosis nigricans, acrochordons, keratosis pilaris, striae distensae, cellulite, and plantar hyperkeratosis. Obesity has metabolic effects, such as causing hyperandrogenism and gout, which in turn are associated with cutaneous manifestations. Furthermore, obesity is associated with an increased incidence of bacterial and Candida skin infections, as well as onychomycosis, inflammatory skin diseases, and chronic dermatoses like hidradenitis suppurativa, psoriasis, and rosacea. The association between atopic dermatitis and obesity and the increased risk of skin cancer among obese patients is debatable. Obesity is also related to rare skin conditions and to premature hair graying. As physicians, understanding these clinical signs and the underlying systemic disorders will facilitate earlier diagnoses for better treatment and avoidance of sequelae.