Increased physical activity promotes skin clearance, improves cardiovascular and psychological health, and increases functional capacity in patients with psoriasis

Abstract

Patients with psoriasis are less physically active compared to age‐matched controls, due to psoriasis‐specific barriers, which significantly limits their ability to benefit from health‐promoting levels of physical activity (PA). In addition, long‐term health outcomes for people with psoriasis are poor and include depression, metabolic syndrome and cardiovascular disease (CVD); presenting a significant challenge to healthcare services.We designed a PA intervention in partnership with patients with psoriasis hypothesising this may have therapeutic utility in the management of psoriasis.Participants with chronic plaque psoriasis were recruited to a single‐centre, 20‐week, prospective cohort study. A wrist‐worn accelerometer (GENEActiv Original; Activinsights Ltd) and a hip‐worn pedometer (Onwalk 900; Decathlon Group) were used objectively measure levels of PA. Our 10‐week PA intervention comprised twice weekly 60‐min walks within three different greenspaces in Greater Manchester, each led by a Sports and Exercise Scientist to deliver a pre‐specified volume/dose of activity. During weeks‐11–20 of the study, participants followed independent activities. Clinical evaluation, including assessment of psoriasis severity, cardiometabolic parameters, psychological wellbeing and functional capacity was made at baseline, week‐10 and ‐20.Sixteen patients with psoriasis completed the study. We observed significantly reduced Psoriasis Area and Severity Index at week‐10 (p = 0.01) and ‐20 (p = 0.001) compared to baseline, with 50% of participants achieving PASI‐50 at week‐20. Dermatology Life Quality Index (DLQI) was significantly reduced at week‐20 (p = 0.04), compared to baseline. Significant reduction in blood pressure at week‐10 (systolic: −7.4 mmHg, p = 0.002; diastolic: −4.2 mmHg, p = 0.03) and ‐20 (systolic: −8.8 mmHg, p = 0.001; diastolic: 4.1 mmHg, p = 0.008) was observed and pulse wave velocity was significantly reduced by week‐20 (p = 0.02), suggesting improvement in cardiovascular health. Despite high prevalence of anxiety and depression at baseline, we documented a significant improvement in wellbeing and psychological health. Functional capacity was significantly enhanced following completion of the study.Increasing PA constitutes a promising therapeutic intervention in the management of psoriasis. Evaluation of our intervention in a clinical trial would help determine clinical utility and establish PA guidelines for patients with psoriasis.