Review

Skin and obesity in childhood: an update

  • Received: 27 November 2021 Accepted: 19 December 2021 Published: 23 December 2021
  • Overweight and obesity have grown in children in the last decades and are now an epidemic, leading to significant public health issues in developed and underdeveloped nations. Obese children have a higher prevalence of skin lesions than normal weight children. The present study is an updated-on state of the art of studies describing the association between childhood obesity and related skin lesions. The most frequent obesity-associated dermatological complications in children are acanthosis nigricans and acrochordons, atopic dermatitis, skin infections, and endocrinological changes including hyperinsulinism and hyperandrogenism. Other common skin manifestations associated with obesity are striae distensae and plantar hyperkeratosis. Although the causes of the majority of the skin lesions associated with obesity are not known, the larger mass of adipose tissue and the secretion of peptides (cytokines, hormones, etc.) from enlarged fat cells due to obesity could lead to skin lesions. Therefore, the prevention of obesity is essential to avoid most skin-associated lesions.

    Citation: Valeria Hirschler. Skin and obesity in childhood: an update[J]. AIMS Medical Science, 2021, 8(4): 311-323. doi: 10.3934/medsci.2021026

    Related Papers:

  • Overweight and obesity have grown in children in the last decades and are now an epidemic, leading to significant public health issues in developed and underdeveloped nations. Obese children have a higher prevalence of skin lesions than normal weight children. The present study is an updated-on state of the art of studies describing the association between childhood obesity and related skin lesions. The most frequent obesity-associated dermatological complications in children are acanthosis nigricans and acrochordons, atopic dermatitis, skin infections, and endocrinological changes including hyperinsulinism and hyperandrogenism. Other common skin manifestations associated with obesity are striae distensae and plantar hyperkeratosis. Although the causes of the majority of the skin lesions associated with obesity are not known, the larger mass of adipose tissue and the secretion of peptides (cytokines, hormones, etc.) from enlarged fat cells due to obesity could lead to skin lesions. Therefore, the prevention of obesity is essential to avoid most skin-associated lesions.



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    Conflict of interest



    The author declares no conflicts of interest in this paper.

    [1] Hales CM, Carroll MD, Fryar CD, et al. (2017) Prevalence of obesity among adults and youth: United States, 2015–2016. NCHS Data Brief 288: 1-8.
    [2] Hirschler V, Lapertosa S, Scaiola ER, et al. (2020) Adiposity, lifestyle behaviors, and cardiometabolic markers in Argentinean schoolchildren. Clin Chim Acta 507: 280-285. doi: 10.1016/j.cca.2020.05.008
    [3] Hirschler V, Buzzano K, Erviti A, et al. (2009) Overweight and lifestyle behaviors of low socioeconomic elementary school children in Buenos Aires. BMC Pediatr 9: 17. doi: 10.1186/1471-2431-9-17
    [4] Cunningham SA, Kramer MR, Narayan KM (2014) Incidence of childhood obesity in the United States. N Engl J Med 370: 403-411. doi: 10.1056/NEJMoa1309753
    [5] Weiss R, Dziura J, Burgert TS, et al. (2004) Obesity and the metabolic syndrome in children and adolescents. N Engl J Med 350: 2362-2374. doi: 10.1056/NEJMoa031049
    [6] Sinha R, Fisch G, Teague B, et al. (2002) Prevalence of impaired glucose tolerance among children and adolescents with marked obesity. N Engl J Med 346: 802-810. doi: 10.1056/NEJMoa012578
    [7] Hirt PA, Castillo DE, Yosipovitch G, et al. (2019) Skin changes in the obese patient. J Am Acad Dermatol 81: 1037-1057. doi: 10.1016/j.jaad.2018.12.070
    [8] Bays HE, González-Campoy JM, Bray GA, et al. (2008) Pathogenic potential of adipose tissue and metabolic consequences of adipocyte hypertrophy and increased visceral adiposity. Expert Rev Cardiovasc Ther 6: 343-368. doi: 10.1586/14779072.6.3.343
    [9] Mirmirani P, Carpenter DM (2014) Skin disorders associated with obesity in children and adolescents: a population-based study. Pediatr Dermatol 31: 183-190. doi: 10.1111/pde.12271
    [10] Hirschler V, Aranda C, Oneto A, et al. (2002) Is acanthosis nigricans a marker of insulin resistance in obese children? Diabetes Care 25: 2353. doi: 10.2337/diacare.25.12.2353
    [11] De Silva NK, Helmrath MA, Klish WJ (2007) Obesity in the adolescent female. J Pediatr Adolesc Gynecol 20: 207-213. doi: 10.1016/j.jpag.2007.03.091
    [12] Dwivedi S, Jhamb R (2010) Cutaneous markers of coronary artery disease. World J Cardiol 2: 262-269. doi: 10.4330/wjc.v2.i9.262
    [13] Toyoda M, Morohashi M (2001) Pathogenesis of acne. Med Electron Microsc 34: 29-40. doi: 10.1007/s007950100002
    [14] Antoniou C, Dessinioti C, Stratigos AJ, et al. (2009) Clinical and therapeutic approach to childhood acne: an update. Pediatr Dermatol 26: 373-380. doi: 10.1111/j.1525-1470.2009.00932.x
    [15] Friedlander SF, Baldwin HE, Mancini AJ, et al. (2011) The acne continuum: an age-based approach to therapy. Semin Cutan Med Surg 30: S6-11. doi: 10.1016/j.sder.2011.07.002
    [16] Williams HC, Dellavalle RP, Garner S (2012) Acne vulgaris. Lancet 379: 361-372. doi: 10.1016/S0140-6736(11)60321-8
    [17] Liy-Wong C, Kim M, Kirkorian AY, et al. (2021) Hidradenitis suppurativa in the pediatric population: an international, multicenter, retrospective, cross-sectional study of 481 pediatric patients. JAMA Dermatol 157: 385-391. doi: 10.1001/jamadermatol.2020.5435
    [18] Bourne S, Jacobs A (1956) Observations on acne, seborrhoea, and obesity. Br Med J 1: 1268-1270. doi: 10.1136/bmj.1.4978.1268
    [19] Rosenfield RL, Ehrmann DA (2016) The pathogenesis of polycystic ovary syndrome (PCOS): the hypothesis of PCOS as functional ovarian hyperandrogenism revisited. Endocr Rev 37: 467-520. 20. doi: 10.1210/er.2015-1104
    [20] Kirby JS, Zaenglein AL (2021) Recognizing the effects and disparities of pediatric hidradenitis suppurativa. JAMA Dermatol 157: 379-380. doi: 10.1001/jamadermatol.2020.5434
    [21] Kohorst JJ, Kimball AB, Davis MD (2015) Systemic associations of hidradenitis suppurativa. J Am Acad Dermatol 73: S27-35. doi: 10.1016/j.jaad.2015.07.055
    [22] Stein I, Leventhal M (1935) Amenorrhea associated with bilateral polycystic ovaries. Am J Obstet Gynecol 29: 181-191. doi: 10.1016/S0002-9378(15)30642-6
    [23] Ibáñez L, Oberfield SE, Witchel S, et al. (2017) An international consortium update: pathophysiology, diagnosis, and treatment of polycystic ovarian syndrome in adolescence. Horm Res Paediatr 88: 371-395. doi: 10.1159/000479371
    [24] Lizneva D, Suturina L, Walker W, et al. (2016) Criteria, prevalence, and phenotypes of polycystic ovary syndrome. Fertil Steril 106: 6-15. doi: 10.1016/j.fertnstert.2016.05.003
    [25] Peña AS, Witchel SF, Hoeger KM, et al. (2020) Adolescent polycystic ovary syndrome according to the international evidence-based guideline. BMC Med 18: 72. doi: 10.1186/s12916-020-01516-x
    [26] Teede HJ, Misso ML, Costello MF, et al. (2018) Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. Clin Endocrinol 89: 251-268. doi: 10.1111/cen.13795
    [27] Pasquali R (2006) Obesity and androgens: facts and perspectives. Fertil Steril 85: 1319-1340. doi: 10.1016/j.fertnstert.2005.10.054
    [28] Al Khalifah RA, Florez ID, Zoratti MJ, et al. (2020) Efficacy of treatments for polycystic ovarian syndrome management in adolescents. J Endocr Soc 5: bvaa155. doi: 10.1210/jendso/bvaa155
    [29] Huang AH, Roh YS, Sutaria N, et al. (2021) Real-world comorbidities of atopic dermatitis in the pediatric ambulatory population in the United States. J Am Acad Dermatol 85: 893-900. doi: 10.1016/j.jaad.2021.03.016
    [30] Kusunoki T, Morimoto T, Nishikomori R, et al. (2008) Obesity and the prevalence of allergic diseases in schoolchildren. Pediatr Allergy Immunol 19: 527-534. doi: 10.1111/j.1399-3038.2007.00686.x
    [31] Ahima RS, Flier JS (2000) Adipose tissue as an endocrine organ. Trends Endocrinol Metab 11: 327-332. doi: 10.1016/S1043-2760(00)00301-5
    [32] Yudkin JS, Stehouwer CD, Emeis JJ, et al. (1999) C-reactive protein in healthy subjects: associations with obesity, insulin resistance, and endothelial dysfunction: a potential role for cytokines originating from adipose tissue? Arterioscler Thromb Vasc Biol 19: 972-978. doi: 10.1161/01.ATV.19.4.972
    [33] Mirza MS (2011) Obesity, visceral fat, and NAFLD: querying the role of adipokines in the progression of nonalcoholic fatty liver disease. ISRN Gastroenterol 2011: 592404. doi: 10.5402/2011/592404
    [34] Silverberg JI, Kleiman E, Lev-Tov H, et al. (2011) Association between obesity and atopic dermatitis in childhood: a case-control study. J Allergy Clin Immunol 127: 1180-1186.e1. doi: 10.1016/j.jaci.2011.01.063
    [35] Falagas ME, Athanasoulia AP, Peppas G, et al. (2009) Effect of body mass index on the outcome of infections: a systematic review. Obes Rev 10: 280-289. doi: 10.1111/j.1467-789X.2008.00546.x
    [36] Honda T, Egawa G, Grabbe S, et al. (2013) Update of immune events in the murine contact hypersen-sitivity model: toward the understanding of allergic contact dermatitis. J Invest Dermatol 133: 303-315. doi: 10.1038/jid.2012.284
    [37] Chen Y, Zhu J, Lyu J, et al. (2020) Association of maternal prepregnancy weight and gestational weight gain with children's allergic diseases. JAMA Netw Open 3: e2015643. doi: 10.1001/jamanetworkopen.2020.15643
    [38] Drucker AM, Pope EI, Field AE, et al. (2019) Association between maternal pre-pregnancy body mass index, gestational weight gain, and offspring atopic dermatitis: a prospective cohort study. J Allergy Clin Immunol Pract 7: 96-102.e2. doi: 10.1016/j.jaip.2018.10.044
    [39] Hrolfsdottir L, Schalkwijk CG, Birgisdottir BE, et al. (2016) Maternal diet, gestational weight gain, and inflammatory markers during pregnancy. Obesity 24: 2133-2139. doi: 10.1002/oby.21617
    [40] Yosipovitch G, DeVore A, Dawn A (2007) Obesity and the skin: skin physiology and skin manifestations of obesity. J Am Acad Dermatol 56: 901-916. doi: 10.1016/j.jaad.2006.12.004
    [41] Guida B, Nino M, Perrino NR, et al. (2010) The impact of obesity on skin disease and epidermal permeability barrier status. J Eur Acad Dermatol Venereol 24: 191-195. doi: 10.1111/j.1468-3083.2009.03503.x
    [42] Shipman AR, Millington GW (2011) Obesity and the skin. Br J Dermatol 165: 743-750. doi: 10.1111/j.1365-2133.2011.10393.x
    [43] Fitzpatrick J (2007)  Dermatology secrets in color Philadelphia: Hanley & Belfus.
    [44] Miró EM, Sánchez NP (2012) Cutaneous manifestations of infectious diseases. Atlas of Dermatology in Internal Medicine New York: Springer, 77-119. doi: 10.1007/978-1-4614-0688-4_7
    [45] Tüzün Y, Wolf R, Bağlam S, et al. (2015) Diaper (napkin) dermatitis: a fold (intertriginous) dermatosis. Clin Dermatol 33: 477-482. doi: 10.1016/j.clindermatol.2015.04.012
    [46] Metin A, Dilek N, Bilgili SG (2018) Recurrent candidal intertrigo: challenges and solutions. Clin Cosmet Investig Dermatol 11: 175-185. doi: 10.2147/CCID.S127841
    [47] Sreeramoju P, Porbandarwalla NS, Arango J, et al. (2011) Recurrent skin and soft tissue infections due to methicillin-resistant Staphylococcus aureus requiring operative debridement. Am J Surg 201: 216-220. doi: 10.1016/j.amjsurg.2009.12.024
    [48] Willey A (2017) Commentary on striae distensae. Dermatol Surg 43: 649-650. doi: 10.1097/DSS.0000000000001042
    [49] Cho S, Park ES, Lee DH, et al. (2006) Clinical features and risk factors for striae distensae in Korean adolescents. J Eur Acad Dermatol Venereol 20: 1108-1113. doi: 10.1111/j.1468-3083.2006.01747.x
    [50] Dowling AM, Steele JR, Baur LA (2004) What are the effects of obesity in children on plantar pressure distributions? Int J Obes Relat Metab Disord 28: 1514-1519. doi: 10.1038/sj.ijo.0802729
    [51] Riddiford-Harland DL, Steele JR, Storlien LH (2000) Does obesity influence foot structure in prepubescent children? Int J Obes Relat Metab Disord 24: 541-544. doi: 10.1038/sj.ijo.0801192
    [52] Scheinfeld NS (2004) Obesity and dermatology. Clin Dermatol 22: 303-309. doi: 10.1016/j.clindermatol.2004.01.001
    [53] Cohen CC, Perng W, Sauder KA, et al. (2021) Associations of nutrient intake changes during childhood with adolescent hepatic fat: the exploring perinatal outcomes among children study. J Pediatr 237: 50-58.e3. doi: 10.1016/j.jpeds.2021.06.027
    [54] Hirschler V, Roque MI, Calcagno ML, et al. (2007) Maternal waist circumference and the prediction of children's metabolic syndrome. Arch Pediatr Adolesc Med 161: 1205-1210. doi: 10.1001/archpedi.161.12.1205
    [55] Geserick M, Vogel M, Gausche R, et al. (2018) Acceleration of BMI in early childhood and risk of sustained obesity. N Engl J Med 379: 1303-1312. doi: 10.1056/NEJMoa1803527
    [56] Hirschler V, Edit S, Miorin C, et al. (2021) Association between high birth weight and later central obesity in 9-year-old schoolchildren. Metab Syndr Relat Disord 19: 213-217. doi: 10.1089/met.2020.0127
    [57] Plachta-Danielzik S, Landsberg B, Johannsen M, et al. (2010) Determinants of the prevalence and incidence of overweight in children and adolescents. Public Health Nutr 13: 1870-1881. doi: 10.1017/S1368980010000583
    [58] Körner A, Kiess W, Vogel M (2019) Persistence of obesity from early childhood onward. N Engl J Med 380: 194-195.
    [59] Hirschler V, Maccallini G, Aranda C, et al. (2012) Lifestyle behaviors and dyslipidemia in Argentinean native versus urban children. Clin Biochem 45: 1161-1166. doi: 10.1016/j.clinbiochem.2012.04.020
    [60] Hirschler V, Oestreicher K, Beccaria M, et al. (2009) Inverse association between insulin resistance and frequency of milk consumption in low-income Argentinean school children. J Pediatr 154: 101-105. doi: 10.1016/j.jpeds.2008.06.036
    [61] Mansoor Y, Hale I (2020) Parent perceptions of routine growth monitoring: a scoping review. Paediatr Child Health 26: 154-158. doi: 10.1093/pch/pxaa041
    [62] Jain A, Sherman SN, Chamberlin LA, et al. (2001) Why don't low-income mothers worry about their preschoolers being overweight? Pediatrics 107: 1138-1146. doi: 10.1542/peds.107.5.1138
    [63] Hirschler V, Gonzalez C, Talgham S, et al. (2006) Do mothers of overweight Argentinean preschool children perceive them as such? Pediatr Diabetes 7: 201-204. doi: 10.1111/j.1399-5448.2006.00183.x
    [64] Toftemo I, Glavin K, Lagerløv P (2013) Parents' views and experiences when their preschool child is identified as overweight: a qualitative study in primary care. Fam Pract 30: 719-723. doi: 10.1093/fampra/cmt056
    [65] Hirschler V, Oestreicher K, Maccallini G, et al. (2010) Relationship between obesity and metabolic syndrome among Argentinean elementary school children. Clin Biochem 43: 435-441. doi: 10.1016/j.clinbiochem.2009.11.003
    [66] Taber DR, Chriqui JF, Powell L, et al. (2013) Association between state laws governing school meal nutrition content and student weight status: implications for new USDA school meal standards. JAMA Pediatr 167: 513-519. doi: 10.1001/jamapediatrics.2013.399
    [67] Pulgaron ER, Delamater AM (2014) Obesity and type 2 diabetes in children: epidemiology and treatment. Curr Diab Rep 14: 508. doi: 10.1007/s11892-014-0508-y
    [68] Hockett CW, Harrall KK, Moore BF, et al. (2019) Persistent effects of in utero overnutrition on offspring adiposity: the exploring perinatal outcomes among children (EPOCH) study. Diabetologia 62: 2017-2024. doi: 10.1007/s00125-019-04981-z
    [69]  Dietary Guidelines for Americans, 2020–2025 and Online Materials Available from: https://www.dietaryguidelines.gov/resources/2020-2025-dietary-guidelines-online-materials.
    [70] Tak YJ, Lee SY (2021) Long-term efficacy and safety of anti-obesity treatment: where do we stand? Curr Obes Rep 10: 14-30. doi: 10.1007/s13679-020-00422-w
    [71] Chanoine JP, Hampl S, Jensen C, et al. (2005) Effect of orlistat on weight and body composition in obese adolescents: a randomized controlled trial. JAMA 293: 2873-2883. doi: 10.1001/jama.293.23.2873
    [72] Son JW, Kim S (2020) Comprehensive review of current and upcoming anti-obesity drugs. Diabetes Metab J 44: 802-818. doi: 10.4093/dmj.2020.0258
    [73] Ryder JR, Kaizer A, Rudser KD, et al. (2017) Effect of phentermine on weight reduction in a pediatric weight management clinic. Int J Obes 41: 90-93. doi: 10.1038/ijo.2016.185
    [74] Allison DB, Gadde KM, Garvey WT, et al. (2012) Controlled-release phentermine/topiramate in severely obese adults: a randomized controlled trial (EQUIP). Obesity 20: 330-342. doi: 10.1038/oby.2011.330
    [75] Kelly AS, Auerbach P, Barrientos-Perez M, et al. (2020) A randomized, controlled trial of liraglutide for adolescents with obesity. N Engl J Med 382: 2117-2128. doi: 10.1056/NEJMoa1916038
    [76] Lean ME, Carraro R, Finer N, et al. (2014) Tolerability of nausea and vomiting and associations with weight loss in a randomized trial of liraglutide in obese, non-diabetic adults. Int J Obes 38: 689-697. doi: 10.1038/ijo.2013.149
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