Increased physical activity promotes skin clearance, improves cardiovascular and psychological health, and increases functional capacity in patients with psoriasis.

Background: Patients with psoriasis are less physically active compared to age-matched controls, due to psoriasis-specific barriers, which significantly limits their ability to benefit from health-promoting levels of physical activity. In addition, long-term health outcomes for people with psoriasis are poor and include depression, metabolic syndrome and cardiovascular disease (CVD); presenting a significant challenge to healthcare services.

Objectives: We designed a physical activity intervention in partnership with patients with psoriasis hypothesising this may have therapeutic utility in the management of psoriasis.

Methods: Participants with chronic plaque psoriasis were recruited to a single-centre, 20-week, prospective cohort study. A wrist-worn accelerometer (GENEActiv Original; Activinsights Ltd, Kimbolton, UK) and a hip-worn pedometer (Onwalk 900; Decathlon Group, Villeneuve d’Ascq, France) were used objectively measure levels of physical activity. Our 10-week physical activity intervention comprised twice weekly 60-minute walks within three different greenspaces in Greater Manchester, each led by a Sports and Exercise Scientist to deliver a pre-specified volume/dose of activity. During weeks-11-20 of the study, participants followed independent activities. Clinical evaluation, including assessment of psoriasis severity, cardiometabolic parameters, psychological wellbeing and functional capacity was made at baseline, week-10 and -20.

Results: Sixteen patients with psoriasis completed the study. We observed significantly reduced Psoriasis Area and Severity Index (PASI) at week-10 (p=0.01) and -20 (p=0.001) compared to baseline, with 50% of participants achieving PASI-50 at week-20. Dermatology Life Quality Index (DLQI) was significantly reduced at week-20 (p=0.04), compared to baseline. Significant reduction in blood pressure at week-10 (systolic: -7.4mmHg, p=0.002; diastolic: -4.2mmHg, p=0.03) and -20 (systolic: -8.8mmHg, p=0.001; diastolic: 4.1mmHg, p=0.008) was observed and pulse wave velocity was significantly reduced by week-20 (p=0.02), suggesting improvement in cardiovascular health. Despite high prevalence of anxiety and depression at baseline, we documented a significant improvement in wellbeing and psychological health. Functional capacity was significantly enhanced following completion of the study.

Conclusion: Increasing physical activity constitutes a promising therapeutic intervention in the management of psoriasis. Evaluation of our intervention in a clinical trial would help determine clinical utility and establish physical activity guidelines for patients with psoriasis.