Psoriasis is a chronic skin immune-mediated disease with systemic pro-inflammatory activation; both genetic and lifestyles factors contribute to its pathogenesis and severity. In this context, nutrition plays a significant role, per se, in
psoriasis' pathogenesis.
Obesity is another important risk factor for
psoriasis, and
weight reduction may improve
psoriasis' clinical severity. The excess
body weight, particularly visceral fat mass, can affect both drug's pharmacokinetics and pharmacodynamics. Therefore,
psoriasis and
obesity share a certain degree of synergy, and the chronic inflammatory state represents the basis of this vicious cycle. Evidence reported that nutrition has different impact on the clinical severity of
psoriasis, though some specific diets have been more investigated in clinical studies compared to others. Diets with systemic anti-inflammatory properties seem to have a higher effect on improving the clinical severity of
psoriasis. Of interest, very-low-calorie
ketogenic diet (VLCKD), through the production of
ketone bodies, has been associated with both a significant reduction of
body weight and inflammatory state. VLCKD leading to both
weight loss and reduction of systemic
inflammation may decrease the exacerbation of the clinical manifestations or even it may block the trigger of psoriatic disease. This dietary pattern could represent a potential first-line treatment in psoriatic patients with
obesity. The review aims to summarize the current evidence regarding VLCKD and
psoriasis with specific reference to
antioxidant and anti-inflammatory effects of this dietary pattern.