Skin manifestations after bariatric surgery
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RESEARCH ARTICLE
Open Access
Skin manifestations after bariatric surgery Yada Itthipanichpong1, Wilawan Damkerngsuntorn1, Natsinee Tangkijngamvong1, Suthep Udomsawaengsup2, Patchaya Boonchayaanant3, Chanat Kumtornrut1, Stephen J. Kerr4, Pravit Asawanonda1 and Pawinee Rerknimitr1*
Abstract Background: Skin signs observed in morbid obesity may change as the weight reduces, especially post-bariatric surgery (BaS). Data concerning the skin findings exclusively in post-BaS patients remain limited. Methods: Seventy post-BaS patients were examined for cutaneous abnormalities. The patients were divided into those with successful weight loss (% excessive body weight loss (EBWL) of at least 50%) and a non-successful group (%EBWL < 50%). Results: Forty-six patients with successful weight loss demonstrated a significantly lower prevalence of acanthosis nigricans on the neck, axillae and inguinal areas, keratosis pilaris (KP) and pebble fingers. However, a higher prevalence of alopecia was observed. After adjustment with patients’ factors, KP (adjusted odds ratio (aOR) = 0.21, 95%CI 0.06–0.74, p = 0.02) and pebble fingers (aOR = 0.09, 95%CI 0.01–0.89, p = 0.04) remained significantly less likely in patients with successful weight loss. Laboratory results comparing pre- and post-surgery values revealed significant decreases in fasting plasma glucose, hemoglobin A1c, and triglyceride and an increase of high-density lipoproteins in both groups. However, significant decreases of liver aminotransferases (AST and ALT) were observed only in the successful group (p = 0.04, 0.003). Nonetheless, a decrease in vitamin B12 (p = 0.01) was observed in the successful group. Conclusion: Weight loss after BaS provided an improvement for metabolic profiles. Successful weight reduction resulted in better skin improvement. However, nutritional supplements may be necessary. Trial registration: Thai Clinical Trials Registry TCTR20171003002. Registered October 3. 2017, retrospectively registered. Keywords: Skin, Cutaneous sign, Obesity, Bariatric surgery, Weight loss
Background Obesity represents one of the major health concerns on a global scale. Substantial increases in the prevalence of patients with obesity has raised the public awareness over decades. The prevalence of overweight individuals (body mass index (BMI) ≥ 25 kg/m2) was reported to be as high as 40% of the total world population [1]. Obesity has various impacts on the skin, including changes in skin physiology, myriads of skin manifestations and aggravation of skin diseases. * Correspondence: [email protected] 1 Division of Dermatology, Department of Medicine, Faculty of Medicine, Skin and Allergy Research Unit, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok 10330, Thailand Full list of author information is available at the end of the article
Skin signs associated with obesity may be divided into those that occur as a result of insulin resistance such as acanthosis nigricans (AN) [2–4] acrochordons [3, 4], and keratosis pilaris (KP) [3–5]. Additionally, mecha
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