Psoriasis is a chronic inflammatory skin disease associated with significant cardiovascular, metabolic, and psychological co-morbidities(1). People living with psoriasis (PLwP) frequently report modifying their diet to try and improve symptoms, often by cutting out whole food groups. However, there are no evidence-based dietary guidelines for psoriasis and the majority do not discuss dietary changes with a healthcare professional (HCP)(Reference Afifi, Danesh and Lee2). Following restrictive diets without the guidance of HCPs, can result in micronutrient deficiencies and affect quality of life(Reference Malik, Tonstad and Paalani3,Reference Simons, Taft and Doerfler4) . There is an absence of studies investigating the experience of PLwP and the perceived role and use of diet. None have been conducted in the UK. With the significant impact on quality of life and co-morbidities associated with psoriasis, understanding the perceived role of diet in the management of psoriasis and patient experience will play a key role in holistic care for people with psoriasis. This study aims to gain insight into the perceived role and use of diet in the management of psoriasis from adults with lived experience in the UK.
Qualitative semi-structured interviews with UK adults with plaque psoriasis (n = 9) were conducted to explore the perceived role of diet in the management of psoriasis. Interviews were transcribed and coded using NVivo software. The data was analysed thematically using a reflexive thematic approach(5).
All participants in the study (n = 9) perceived there to be a role for diet in the management of psoriasis. The majority tried restrictive diets including vegan, dairy- and gluten-free, and “cleansing” diets to help manage their psoriasis. The most frequently used sources for dietary information and recommendations were social media and public forums. Participants highlighted the confusion and burden of not having reputable guidance about nutrition, despite the vast information available online, and reported that dietary support from a HCP would be helpful. Disease flare-ups, not wanting to increase medication (and potential side-effects), before and after photos on social media and recommendations from other PLwP were frequently mentioned as reasons for trialing diets or factors that influenced dietary decisions.
Findings from this study suggest that people with psoriasis rely on popular online literature for dietary recommendations. These are often restrictive and sourced from unregulated platforms. Following fad-diets long-term or restrictive diets without the guidance of HCPs can result in micronutrient deficiencies. This study also highlights the cognitive burden faced by PLwP when considering dietary changes to help alleviate symptoms. The findings of this study, combined with the absence of evidence in the literature, highlights the need for research aimed at understanding the role of diet in psoriasis symptom management and how best to support people with psoriasis, in the absence of dietary guidance.
