Nutritional status in children with the severe course of psoriasis

Introduction. Assessment of nutritional status in children with severe psoriasis is very important, considering the high incidence of overweight and obesity in patients with psoriasis, disorders of lipid metabolism and glucose tolerance, and the pathogenetic relationship between these conditions and psoriasis. The aim: to assess the growth of children with severe psoriasis.
Materials and methods. A retrospective cohort study included 500 children (275 boys, 55%; 225 girls, 45%) aged of from 4 to 17 years 11 months with severe vulgar psoriasis (PASI > 10). Patients’ medical histories were used to obtain data. The severity of clinical manifestations of psoriasis was assessed using the PASI index. In all patients, clinical assessment, anthropometric data (height, weight) were performed on admission. Anthropometric data analysis was accomplished through Z-scores calculation with Anthro/AnthroPlus software.
Results. Adequate nutritional status was established in 66% of patients. Malnutrition was diagnosed in 34% of children. Overweight (19,5%) and obesity (13%) were detected in 32,6% of patients. Moderate acute undernutrition was diagnosed in 1.1%. A direct moderate statistically significant correlation (r = 0.58; p = 0.05) was revealed between the PASI and the WAZ, and a direct strong statistically significant correlation (r = 0.68; p = 0.02) between the PASI and body weight in children aged of from 4 to 7 years.
Conclusion. A trend toward more severe progression of skin lesions has been observed in patients with psoriasis with higher body weight indicers, suggesting an increased risk of developing metabolic syndrome in this category of patients and highlighting optimization of their nutrition.

children, psoriasis, nutritional status, overweight, obesity, metabolic syndrome

1. Cho S.I., Kim Y.E., Jo S.J. Association of metabolic comorbidities with pediatric psoriasis: a systematic review and meta-analysis. Ann. Dermatol. 2021; 33(3): 203–13. https://doi.org/10.5021/ad.2021.33.3.203

2. Wang J., Yu Y., Liu L., Wang C., Sun X., Zhou Y., et al. Global prevalence of obesity in patients with psoriasis: An analysis in the past two decades. Autoimmun. Rev. 2024; 23(6): 103577. https://doi.org/10.1016/j.autrev.2024.103577

3. Fortina A.B., Bardazzi F., Berti S., Carnevale C., Di Lernia V., El Hachem M., et al. Treatment of severe psoriasis in children: recommendations of an Italian expert group. Eur. J. Pediatr. 2017; 176(10): 1339–54. https://doi.org/10.1007/s00431-017-2985-x

4. Schwarz C.W., Loft N., Rasmussen M.K., Nissen C.V., Dam T.N., Ajgeiy K.K., et al. Predictors of response to biologics in patients with moderate-to-severe psoriasis: a Danish nationwide cohort study. Acta Derm. Venereol. 2021; 101(10): adv00579. https://doi.org/10.2340/actadv.v101.351

5. Mortato E., Talamonti M., Marcelli L., Megna M., Raimondo A., Caldarola G., et al. Predictive factors for super responder status and long-term effectiveness of guselkumab in psoriasis: a multicenter retrospective study. Dermatol. Ther. (Heidelb). 2025; 15(5): 1239–50. https://doi.org/10.1007/s13555-025-01394-2

6. Ismail A.M.A., Saad A.E., Draz R.S. Effect of low-calorie diet on psoriasis severity index, triglycerides, liver enzymes, and quality of life in psoriatic patients with non-alcoholic fatty liver disease. Reumatologia. 2023; 61(2): 116–22. https://doi.org/10.5114/reum/162995

7. Pinter A., Schwarz P., Gerdes S., Simon J.C., Saalbach A., Rush J., et al. Biologic treatment in combination with lifestyle intervention in moderate to severe plaque psoriasis and concomitant metabolic syndrome: rationale and methodology of the metabolyx randomized controlled clinical trial. Nutrients. 2021; 13(9): 3015. https://doi.org/10.3390/nu13093015

8. De Simoni E., Rizzetto G., Molinelli E., Capodaglio I., Offidani A., Simonetti O. The role of diet in children with psoriasis: emerging evidence and current issues. Nutrients. 2023; 15(7): 1705. https://doi.org/10.3390/nu15071705

9. Fredriksson T., Pettersson U. Severe psoriasis — oral therapy with a new retinoid. Dermatologica. 1978; 157(4): 238–44. https://doi.org/10.1159/000250839

10. WHO. AnthroPlus for Personal Computers: Software for assessing growth of the world’s children and adolescents. Geneva; 2009.