Nutrition and psoriasis

doi:10.1016/j.clindermatol.2010.03.027

Clinics in Dermatology

Volume 28, Issue 6, November–December 2010, Pages 615-626

https://doi.org/10.1016/j.clindermatol.2010.03.027 Get rights and content

Abstract

Nutritional supplementation may provide a viable treatment alternative in patients with psoriasis. Randomized, controlled trials have shown the effectiveness of topical vitamin A and D derivatives, intravenous ω-3 fatty acids, oral inositol, and various combined therapies. Dual therapies of ultraviolet B phototherapy and fish oil, retinoids and thiazolidinediones, and cyclosporine and a low-calorie diet were effective in the treatment of psoriasis in randomized, controlled trials. This contribution also reviews the potential negative effect of alcohol and the potential positive effects of vitamin B₁₂, selenium, retinoic acid metabolism-blocking agents, and a gluten-free diet in the treatment of psoriasis.

Introduction

The role of nutrition in the treatment of psoriasis has been studied for many years. Most recently, the observation of comorbid conditions associated with psoriasis has stimulated renewed interest in nutrition as a way to improve comorbid conditions in addition to underlying skin disease.

The efficacy of vitamin A and vitamin D derivatives has been well established. Topical corticosteroids and topical vitamin D analogues are effective for chronic plaque psoriasis. Vitamin A derivatives applied topically may also potentially confer benefit.¹ The ω-3 polyunsaturated fatty acids (eicosapentaenoic acid [EPA] or docosahexanoic acid [DHA], or both) administered topically, orally, and intravenously all have reported benefits in psoriasis if taken in high enough doses and may be useful as adjuvant therapy. Similarly, changes in dietary behaviors may help to augment the effect of well-established treatments. Limitation of alcohol use, adoption of a low-calorie or gluten-free diet, or treatment of comorbid conditions, when applicable to a particular patient, may hasten clearing of psoriatic lesions in patients undergoing phototherapy or receiving topical or systemic medications. Vitamin B₁₂ and select antioxidants may also provide some benefit. Although many dermatologists often overlook the role of nutrition in the treatment of psoriasis, consideration of nutritional alternatives in select patients may help to enhance care.

Section snippets

Fish oil and psoriasis

The mechanism of action of fish oil in the treatment of psoriasis is based widely on the alteration of serum and epidermal and blood cell membrane lipid composition. Arachidonic acid (AA) is found in high levels in psoriatic skin lesions, and its metabolite, leukotriene B4, is thought to be a mediator of inflammation in psoriasis.² When the ω-3 polyunsaturated fatty acid EPA is metabolized by cyclooxygenase or lipoxygenase, or both, in place of AA in cell membranes, it may help to mitigate

Alcohol and psoriasis

Do patients with psoriasis have poor dietary and alcohol abuse habits that may increase their risk of developing psoriasis and adversely affect their disease course and overall prognosis? Do the dietary and alcohol habits of psoriatic patients influence their development of comorbid conditions? The directionality of these associations is not yet clear.

Alcohol consumption may predispose individuals, especially men with a family history of psoriasis, to developing psoriasis.23, 24 This

Low-calorie diet and psoriasis

Many studies have evaluated the effect of calorie restriction in psoriasis; however, none has provided consistent evidence for a benefit of calorie restriction over an extended period of time.29, 30 Calorie restriction as adjuvant therapy with cyclosporine in obese patients with psoriasis was evaluated. A randomized, controlled, investigator-blinded clinical trial was conducted on 61 obese patients (body mass index >30 kg/m²) with moderate to severe chronic plaque psoriasis given low dose

Metabolic syndrome and psoriasis

Metabolic syndrome has been defined as the presence of dyslipidemia, glucose intolerance, obesity, and hypertension.³² Several studies have suggested an increased prevalence of each of the components of metabolic syndrome in patients with psoriasis33, 34, 35, 36 as well as an increased prevalence of atherosclerosis.³⁷ Other investigators have found a higher presence of dyslipidemias in active and inactive psoriasis vs healthy controls.³⁸ A prospective evaluation of women nurses between 1991 and

Gluten-free diet and psoriasis and celiac disease

The mechanism by which celiac disease might be related to psoriasis is currently unclear. Both conditions involve Th1 cytokines in the pathogenesis of the disease process. Interleukins (IL)-1 and IL-8 released from rapidly dividing keratinocytes are thought to activate the Th1 inflammatory cascade.⁴⁴ Although a clear association between celiac disease and psoriasis has not yet been established, several researchers suggest an increased association,44, 45, 46 whereas others deny any association.47

Vitamin B₁₂ and psoriasis

When levels of vitamin B₁₂ in psoriatic plaques were low, researchers examined the potential use of vitamin B₁₂ in the treatment of psoriasis. Studies have shown efficacy with intramuscular and systemic vitamin B₁₂.57, 58 The benefit in topical vitamin B₁₂ was also demonstrated recently. A randomized, prospective clinical trial evaluated the effects of topical calcipotriol cream vs vitamin B₁₂ cream (700 mg/kg methyl glycoside stearate) containing avocado oil (containing 82.9 mg/kg vitamin E, α

Oral vitamin D and psoriasis

Although the role of topical vitamin D in the treatment of psoriasis has been well established, the mechanism of action has yet to be fully elucidated. Calcitriol (1,25 dihydroxyvitamin D₃ [1,25(OH)2-D₃]), the biologically active form of vitamin D, and its analogues act through binding the vitamin D receptor (VDR), a member of the steroid/thyroid hormone nuclear receptor superfamily. VDR is a ligand-dependent transcription factor that forms heterodimers with other nuclear receptors, including

Selenium and psoriasis

Selenium in high and low doses has an inhibitory effect on DNA synthesis and a stimulatory effect on and cellular proliferation. Selenium is also known for its UVA and UVB protective, antioxidant, and anti-inflammatory effects.⁷² As an antioxidant, selenium provides for some glutathione peroxidase activity in vivo. One study examined the effect of selenium and vitamin E on patients with depressed glutathione peroxidase levels. Levels of glutathione peroxidase increased after 6 to 8 weeks of

Topical and systemic vitamin A and psoriasis

Various topical and systemic vitamin A derivatives are highly effective in the treatment of psoriasis. There are two families of retinoid receptors: retinoic acid receptors and retinoid X receptors, and each family has α, β, and γ subtypes.⁶⁰ Through these receptors, retinoids may act to inhibit the growth of hyperproliferative keratinocytes and induce their terminal differentiation.⁶¹

There are conflicting reports regarding the serum vitamin A level in patients with psoriasis. Serum vitamin A

Inositol and zinc in psoriasis

A randomized, placebo-controlled, double-blind trial demonstrated a significant improvement in the PASI score in lithium-treated patients taking inositol (6 g/d) vs a lactose placebo for 10 weeks.⁹¹ Zinc supplementation, however, did not produce a significant improvement in PASI score in well-designed clinical trials.⁹²

Taurine in psoriasis

Although early observations suggested the amino acid taurine was involved in the pathogenesis of psoriasis, a series of studies failed to confirm that excessive or restricted taurine could exacerbate or ameliorate, respectively, the clinical course of psoriasis. In an initial study of 12 patients with chronic psoriasis treated with cholestyramine, a bile-acid sequestrant, all patients experienced clinical improvement and a concomitant increase in fecal taurine content. These results suggested

Conclusions

As summarized in Table 1, nutrition, nutritional supplements, low-calorie or gluten-free diets, and alcohol abstinence may have a role in the treatment of psoriasis and its comorbidities. Future investigations are merited, because these treatments are inexpensive and safer than immunosuppressives and biologics.

References (98)

KojimaT. et al.
Effect of highly purified eicosapentaenoic acid on psoriasis
J Am Acad Dermatol
(1989)
KettlerA.H. et al.
Effect of dietary fish oil supplementation on psoriasis
J Am Acad Dermatol
(1988)
BittinerS.B. et al.
A double-blind, randomised, placebo-controlled trial of fish oil in psoriasis
Lancet
(1988)
MayserP. et al.
ω-3 Fatty acid-based lipid infusion in patients with chronic plaque psoriasis: Results of a double-blind, randomized, placebo-controlled, multicenter trial
J Am Acad Dermatol
(1998)
AshleyJ.M. et al.
Fish oil supplementation results in decreased hypertriglyceridemia in patients with psoriasis undergoing etretinate or acitretin therapy
J Am Acad Dermatol
(1988)
SantosJ. et al.
Effects of fish oil in cyclosporine-treated renal transplant recipients
Transplant Proc
(2000)
GuptaM.A. et al.
Alcohol intake and treatment responsiveness of psoriasis: a prospective study
J Am Acad Dermatol
(1993)
GisondiP. et al.
Weight loss improves the response of obese patients with moderate-to-severe chronic plaque psoriasis to low-dose cyclosporine therapy: a randomized, controlled, investigator-blinded clinical trial
Am J Clin Nutr
(2008)
NeimannA.L. et al.
Prevalence of cardiovascular risk factors in patients with psoriasis
J Am Acad Dermatol
(2006)
ShapiroJ. et al.
The association between psoriasis, diabetes mellitus, and atherosclerosis in Israel: a case-control study
J Am Acad Dermatol
(2007)

Rocha-PereiraP. et al.

Dislipidemia and oxidative stress in mild and severe psoriasis as a risk for cardiovascular disease

Clin Chim Acta

(2001)

OjettiV. et al.

High prevalence of celiac disease in psoriasis

Am J Gastroenterol

(2003)

BosJ.D. et al.

Topical treatments in psoriasis: today and tomorrow

Clin Dermatol

(2008)

SmithE.L. et al.

A novel approach for the evaluation and treatment of psoriasis

J Am Acad Dermatol

(1988)

el-AzharyR.A. et al.

Efficacy of vitamin D3 derivatives in the treatment of psoriasis vulgaris: a preliminary report

Mayo Clin Proc

(1993)

ParkB. et al.

Vitamin D receptor polymorphism is associated with psoriasis

J Invest Dermatol

(1999)

HolickM.F.

High prevalence of vitamin D inadequacy and implications for health

Mayo Clin Proc

(2006)

SerwinA.B. et al.

Selenium status in psoriasis and its relations to duration and severity of the disease

Nutrition

(2003)

KharaevaZ. et al.

Clinical and biochemical effects of coenzyme Q10, Vitamin E, and Selenium supplementation to psoriasis patients

Nutrition

(2009)

SerwinA.B. et al.

Selenium supplementation, soluble tumor necrosis factor-alpha receptor type 1, and C-reactive protein during psoriasis therapy with narrowband ultraviolet B

Nutrition

(2006)

SerwinA.B. et al.

Soluble tumor necrosis factor-alpha receptor type 1 during selenium supplementation in psoriasis patients

Nutrition

(2003)

RoeD.A.

The clinical and biochemical significance of taurine excretion in psoriasis

J Invest Dermatol

(1962)

ZackheimH.S. et al.

Taurine and psoriasis

J Invest Dermatol

(1968)

MasonA.R. et al.

Topical treatments for chronic plaque psoriasis

Cochrane Database Syst Rev

(2009)

GuptaA.K. et al.

Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis

Br J Dermatol

(1989)

MauriceP.D. et al.

The effects of dietary supplementation with fish oil in patients with psoriasis

Br J Dermatol

(1987)

ZibohV.A. et al.

Effects of dietary supplementation of fish oil on neutrophil and epidermal fatty acids. Modulation of clinical course of psoriatic subjects

Arch Dermatol

(1986)

KragballeK. et al.

Low-fat diet supplemented with dietary fish oil (MAX-EPA) and results in improvement of psoriasis and in formation of leukotriene B5

Acta Derm Venereol

(1989)

SchenaD. et al.

Increased erythrocyte membrane arachidonate and platelet malondialdehyde (MDA) production in psoriasis: normalization after fish oil

Acta Derm Venereol (Stockh)

(1989)

BjørneboeA. et al.

Effect of dietary supplementation with n-3 Fatty Acids

Br J Dermatol

(1988)

SoylandE. et al.

Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis

N Engl J Med

(1993)

DannoK. et al.

Combination therapy with low-dose etretinate and eicosapentaenoic acid for psoriasis vulgaris

J Dermatol

(1998)

GuptaA.K. et al.

The role of fish oil in psoriasis. A randomized, double-blind, placebo-controlled study to evaluate the effects of fish oil and topical corticosteroid therapy in psoriasis

Int J Dermatol

(1990)

EscobarS.O. et al.

Topical fish oil in psoriasis—a controlled and blind study

Clin Exp Dermatol

(1992)

Henneicke-von ZepelinH.H. et al.

Highly purified omega-3-polyunsaturated fatty acids for topical treatment of psoriasis. Results of a double-blind, placebo-controlled multicentre study

Br J Dermatol

(1993)

GrimmingerF. et al.

A double-blind, randomized, placebo-controlled trial of n-3 fatty acid based lipid infusion in acute, extended guttate psoriasis. Rapid improvement of clinical manifestations and changes in neutrophil leukotriene profile

Clin Investig

(1993)

MarsdenJ.R.

Effect of dietary fish oil on hyperlipidaemia due to isotretinoin and etretinate

Hum Toxicol

(1987)

ElzingaL. et al.

Modification of experimental nephrotoxicity with fish oil as the vehicle for cyclosporin

Transplantation

(1987)

StoofT.J. et al.

Does fish oil protect renal function in cyclosporin-treated psoriasis patients?

J Intern Med

(1989)

JankovicS. et al.

Risk factors for psoriasis: a case-control study

J Dermatol

(2009)

BehnamS.M. et al.

Alcohol as a risk factor for plaque-type psoriasis

Cutis

(2005)

ZamboniA.

Dietary behavior in psoriatic patients

Acta Derm Venereol (Stockh)

(1989)

PoikolainenK. et al.

Smoking, alcohol and life events related to psoriasis among women

Br J Dermatol

(1994)

PoikolainenK. et al.

Excess mortality related to alcohol and smoking among hospital-treated patients with psoriasis

Arch Dermatol

(1999)

LithellH. et al.

A fasting and vegetarian diet treatment trial on chronic inflammatory disorders

Acta Derm Venereol (Stockh)

(1983)

RucevicI. et al.

The role of the low energy diet in psoriasis vulgaris treatment

Coll Antropol

(2003)

SaracenoR. et al.

Does metabolic syndrome influence psoriasis?

Eur Rev Med Pharmacol Sci

(2008)

CohenA.D. et al.

Meyerovitch. Association between psoriasis and the metabolic syndrome

Dermatol

(2008)

SommerD.M. et al.

Increased prevalence of the metabolic syndrome in patients with moderate to severe psoriasis

Arch Dermatol Res

(2006)

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This immune-mediated skin disease is characterized by the production of reactive oxygen species due to the overexpression of pro-inflammatory cytokines. The development of psoriasis is associated with genetic predisposition, immune disorders (Huerta et al., 2007), oxidative stress or environmental risk factors such as diet, alcohol consumption, stress, obesity and smoking (Wacewicz et al., 2017; Ricketts et al., 2010). Vitiligo is an acquired, idiopathic and autoimmune disease that progressively damages melanocytes in the skin, resulting in the development of white patches (Lai et al., 2017; Speeckaert and van Geel, 2017).
Psoriasis and vitiligo are common, autoimmune skin diseases, their etiology is still unclear. The relationship between environmental factors including diet and various skin diseases has been studied. The general mechanism of cadmium (Cd), lead (Pb) and mercury (Hg) toxicity is through the production of reactive oxygen species which are known to play a role in etiopathogenesis of skin disorders.
The aim of this study was to estimate the influence of dietary habits on the concentration of Cd, Pb and Hg in the peripheral blood samples of patients with psoriasis and vitiligo.
In this case-control study, sixty patients with psoriasis, fifty patients with vitiligo and fifty eight healthy people were examined. Blood levels of Cd, Pb and Hg were determined by atomic absorption spectrometry. Food-frequency questionnaires were implemented to collect the dietary data.
Significant differences (p < 0.05) of Cd levels were found between women and men with psoriasis and women and men in the control group. The concentration of Pb was significantly higher among vitiligo patients (50.04 ± 26.54 μg/L) than in healthy controls (36.04 ± 27.35 μg/L). Significantly lower ratio of Se/Pb, Zn/Pb and Cu/Pb was found among psoriatic men. Significantly (p < 0.05) lower values of Se/Hg ratio were observed among vitiligo patients compared to controls.
The elevated levels of toxic elements could increase oxidative stress which may partly contribute to inflammation in the pathogenesis of psoriasis and vitiligo, which requires further research. Analysis of the influence of frequent consumption of food products on toxic metals concentration showed that the dietary habits have impact on the content of examined toxic metals in the blood of patients. The obtained results may be useful for composing the diet and could be helpful in prevention of psoriasis and vitiligo.
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Fatty acids are important structural components that are required for the metabolic events. Polyunsaturated fatty acids (PUFAs) include multiple double bonds while monounsaturated fatty acids (MUFAs) have one double bond which makes them different from the other fatty acids in the cis configuration in their chemical structure. Such fatty acids have benefits which are positive and protective on human health and development including decrease in the risk of cardiovascular diseases which have risk of death, effects in cancer prevention and treatment, attenuation of the risk of Alzheimer's disease, relieve of clinical symptoms in skin diseases, asthma, allergic diseases, rheumatoid arthritis, eczema, seborrhoeic dermatitis, psoriasis, and reduction in the risk of diabetes. In this chapter, sources, extraction techniques, bioavailability, stability, safety, and toxicology, and health benefits of PUFAs and MUFAs will be discussed.
Concentration of selenium, zinc, copper, Cu/Zn ratio, total antioxidant status and c-reactive protein in the serum of patients with psoriasis treated by narrow-band ultraviolet B phototherapy: A case-control study
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Psoriasis is a common, an inflammatory skin disease. Trace elements may play an active role in the pathogenesis of psoriasis.
The aim of this study was to estimate the concentration of selenium (Se), zinc (Zn), copper (Cu) and Cu/Zn ratio as well as total antioxidant status (TAS) and c-reactive protein (CRP) in the serum of patients with psoriasis.
In this case-control study sixty patients with psoriasis and fifty-eight healthy people were examined. Serum levels of Se, Zn and Cu were determined by atomic absorption spectrometry. Cu/Zn ratio was calculated. TAS was measured spectrophotometrically. CRP was analyzed by immunoturbidimetric method. Clinical activity of psoriasis was evaluated using Psoriasis Area and Severity Index (PASI).
Serum concentration of Se in patients with psoriasis (71.89 ± 16.90 μg/L) was lower as compared to the control group (79.42 ± 18.97 μg/L) and after NB-UVB. Cu level of patients was higher (1.151 ± 0.320 mg/L) as compared to controls (1.038 ± 0.336 mg/L), but Zn level did not differ. We observed higher Cu/Zn ratio (p < 0.05) in examined patients than in the control group and after NB-UVB. We found decrease TAS before and after NB-UVB. CRP levels was found to be normal range. A significant correlation coefficient between CRP and Cu/Zn was observed.
The study showed some disturbances in the serum levels of trace elements and TAS in psoriatic patients.
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It is unclear whether supplementation with vitamin D improves disease, but a recent randomized double-blind trial of 107 patients with AD found benefit.38 Topical treatment of psoriasis with vitamin D and A analogues and systemic retinoids has been well established, but the role of systemic supplementation with other vitamins and nutrients is less clear.39 Burgeoning evidence that psoriasis is a systemic inflammatory process with links to comorbidities including metabolic syndrome,40 adult cardiac disease,41 and depression42 further prioritizes the need to consider nutrition and diet as potential recommendations for psoriasis patients.
There has been a surge of new data regarding the pathophysiology of skin diseases. We are appreciating the sophisticated interplay among the skin, the immune system, and the environment. More elegant and highly specific medicines have been designed to target certain immune mediators of the adaptive immune system. In parallel fashion, we are learning more about the elegance of the innate immune system and how nutrition as early as the prenatal period can affect the priming of other immune cells. Concerns about the long-term impact of new immune-modulating medicines—especially in the pediatric population—have patients asking their dermatologists for nutritional alternatives to medical therapies. Nutrients and nutritional therapies appear to play a role at different ages for different dermatoses. Probiotics are showing promise as a therapeutic option for patients older than 1 year for atopic dermatitis. Systemic contact allergens appear to be a bigger burden on the adult population with atopic dermatitis. Obesity is a growing concern for both children and adults with psoriasis. Milk and high glycemic foods have a strong impact on the teenage acne population. Vitamins A and D are addressed as piece of the alopecia areata puzzle. Zinc and homeopathy are presented finally as possible treatments to the everlasting wart.
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The objective of this study was to assess the effectiveness of a specific composition of a traditional herbal preparation (DurrDerma) in adult patients with moderate to severe skin psoriasis. The preparation is a newly developed topical combination containing plant-based extracts traditionally used in skin disease as black cumin, olive oil, tea tree oil, cocoa butter completed by vitamin A and vitamin B12. We documented the effectiveness of the preparation in a first case series. A total of 12 patients (8 males and 4 females, 21–86 y) with manifest and treatment-resistant psoriasis were included and treated for 12 weeks. All patients were assigned to twice-daily treatment with the DurrDerma preparation. Treatment success as determined by the Psoriasis Area and Severity Index (PASI) score, the body surface area, and the dermatology life index was achieved (PASI reduction of >75%) in 10 of the 12 treated patients (83%). The remaining two patients showed a PASI reduction of ≤50%. In 5 of the patients PASI reduction was achieved <12 weeks (between week 3–11). The beneficial effect in responder patients might be explained by a synergistic anti-oxidative and anti inflammatory activity of all components present in DurrDerma. We conclude that the new preparation using a traditional approach seems to be a promising complementary treatment for psoriasis.
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Nutrition and psoriasis

Abstract

Introduction

Section snippets

Fish oil and psoriasis

Alcohol and psoriasis

Low-calorie diet and psoriasis

Metabolic syndrome and psoriasis

Gluten-free diet and psoriasis and celiac disease

Vitamin B12 and psoriasis

Oral vitamin D and psoriasis

Selenium and psoriasis

Topical and systemic vitamin A and psoriasis

Inositol and zinc in psoriasis

Taurine in psoriasis

Conclusions

J Am Acad Dermatol

J Am Acad Dermatol

Lancet

J Am Acad Dermatol

J Am Acad Dermatol

Transplant Proc

J Am Acad Dermatol

Am J Clin Nutr

J Am Acad Dermatol

J Am Acad Dermatol

Clin Chim Acta

Am J Gastroenterol

Clin Dermatol

J Am Acad Dermatol

Mayo Clin Proc

J Invest Dermatol

Mayo Clin Proc

Nutrition

Nutrition

Nutrition

Nutrition

J Invest Dermatol

J Invest Dermatol

Topical treatments for chronic plaque psoriasis

Cochrane Database Syst Rev

Double-blind, placebo-controlled study to evaluate the efficacy of fish oil and low-dose UVB in the treatment of psoriasis

Br J Dermatol

The effects of dietary supplementation with fish oil in patients with psoriasis

Br J Dermatol

Effects of dietary supplementation of fish oil on neutrophil and epidermal fatty acids. Modulation of clinical course of psoriatic subjects

Arch Dermatol

Low-fat diet supplemented with dietary fish oil (MAX-EPA) and results in improvement of psoriasis and in formation of leukotriene B5

Acta Derm Venereol

Increased erythrocyte membrane arachidonate and platelet malondialdehyde (MDA) production in psoriasis: normalization after fish oil

Acta Derm Venereol (Stockh)

Effect of dietary supplementation with n-3 Fatty Acids

Br J Dermatol

Effect of dietary supplementation with very-long-chain n-3 fatty acids in patients with psoriasis

N Engl J Med

Combination therapy with low-dose etretinate and eicosapentaenoic acid for psoriasis vulgaris

J Dermatol

The role of fish oil in psoriasis. A randomized, double-blind, placebo-controlled study to evaluate the effects of fish oil and topical corticosteroid therapy in psoriasis

Int J Dermatol

Topical fish oil in psoriasis—a controlled and blind study

Clin Exp Dermatol

Highly purified omega-3-polyunsaturated fatty acids for topical treatment of psoriasis. Results of a double-blind, placebo-controlled multicentre study

Br J Dermatol

A double-blind, randomized, placebo-controlled trial of n-3 fatty acid based lipid infusion in acute, extended guttate psoriasis. Rapid improvement of clinical manifestations and changes in neutrophil leukotriene profile

Clin Investig

Effect of dietary fish oil on hyperlipidaemia due to isotretinoin and etretinate

Hum Toxicol

Modification of experimental nephrotoxicity with fish oil as the vehicle for cyclosporin

Transplantation

Does fish oil protect renal function in cyclosporin-treated psoriasis patients?

J Intern Med

Risk factors for psoriasis: a case-control study

J Dermatol

Alcohol as a risk factor for plaque-type psoriasis

Cutis

Dietary behavior in psoriatic patients

Acta Derm Venereol (Stockh)

Smoking, alcohol and life events related to psoriasis among women

Br J Dermatol

Excess mortality related to alcohol and smoking among hospital-treated patients with psoriasis

Vitamin B₁₂ and psoriasis