Why don’t people with psoriasis take enough exercise?

Psoriasis is a chronic skin condition which causes red, scaly patches and affects around 2% of the population. People with psoriasis are more likely than others to suffer cardiovascular disease (e.g. heart attack or stroke). It is well known that regular physical exercise reduces the risk of cardiovascular disease, but, worryingly, people with psoriasis take less exercise than most people. To find out why this might be, doctors in Manchester, U.K., studied 404 adults attending a regional psoriasis clinic. One in five also had arthritis, which can make exercise painful, but responses to the International Physical Activity Questionnaire showed that over half failed to reach the level of physical activity recommended by the American Heart Association. Those who did the least exercise had worse psoriasis and also worse scores on the Dermatology Life Quality Index (DLQI) questionnaire. Women particularly seemed to avoid physical activities, but that is true generally, not just with psoriasis. Having psoriasis can cause embarrassment and low mood which can stop people from wanting to exercise. Detailed analysis of the DLQI questionnaires showed which answers were particularly linked to lower physical activity: these were skin soreness, clothing concerns, avoiding leisure activities and treatment issues. Whatever the reasons for people with psoriasis not exercising, it is important that doctors recognise this problem and explore it with patients. Noticing responses to individual questions in the DLQI, as well as the overall DLQI score, may help doctors understand the particular challenges faced by individual patients in increasing their levels of physical activity. Linked Article:   Auker et al. Br J Dermatol 2020; 183 :1094–1102.