Division of Dermatology, Department of Medicine, Faculty of Medicine, Skin and Allergy Research Unit, Chulalongkorn University, 1873 Rama IV Road, Pathumwan, Bangkok, 10330, Thailand.
Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
BMC Dermatol. 2020 Dec 9;20(1):21. doi: 10.1186/s12895-020-00120-z.
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.
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%).
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.
Weight loss after BaS provided an improvement for metabolic profiles. Successful weight reduction resulted in better skin improvement. However, nutritional supplements may be necessary.
Thai Clinical Trials Registry TCTR20171003002 . Registered October 3. 2017, retrospectively registered.
病态肥胖患者的皮肤征象可能会随着体重的减轻而改变，尤其是在接受减重手术后（BaS）。专门针对 BaS 后患者皮肤表现的数据仍然有限。
对 70 名 BaS 后患者进行皮肤异常检查。将患者分为减重成功组（至少 50%的超重体重减轻（EBWL））和非成功组（EBWL<50%）。
46 名减重成功的患者颈、腋窝和腹股沟部位的黑棘皮病、毛发角化病（KP）和卵石指的患病率显著降低。然而，脱发的患病率却有所升高。在调整了患者因素后，KP（调整后的优势比（aOR）=0.21，95%CI 0.06-0.74，p=0.02）和卵石指（aOR=0.09，95%CI 0.01-0.89，p=0.04）在减重成功的患者中仍显著不太可能发生。比较术前和术后实验室结果显示，两组患者的空腹血糖、糖化血红蛋白和甘油三酯显著降低，高密度脂蛋白升高。然而，只有减重成功组的肝转氨酶（AST 和 ALT）显著降低（p=0.04，0.003）。尽管如此，在减重成功组中观察到维生素 B12 降低（p=0.01）。
BaS 后体重减轻改善了代谢谱。成功减重可改善皮肤状况，但可能需要补充营养。
泰国临床试验注册中心 TCTR20171003002，于 2017 年 10 月 3 日注册，回顾性注册。
