Griffiths CEM, Armstrong AW, Gudjonsson JE, Barker JNWN. Psoriasis. Lancet. 2021 Apr 3;397(10281):1301-1315 A new book on skin health for 2023, "Skin Food: Your 4-step solution to healthy, happy skin", written by qualified dermatologist, Dr Thivi Maruthappu is now available. Dr Marathappu is also an associate member of the Association for Nutrition and a researcher at Kings College, London. Consultant dermatologist and nutritionist Dr Thivi Maruthappu has released a new book highlighting the symbiotic relationship between nutrition and skin health. Whilst it is aimed at the general public, it is also a useful overview about the role of nutrition in skin health for primary healthcare providers. References and sources of further information/support are included to support further self-guided exploration of this fascinating subject.

Psoriasis has been independently linked to ischaemic heart disease, Type 2 diabetes, hyperlipidaemia and hypertension The role of diet and nutrition in the management of psoriasis is a frequent question asked by people living with this chronic, currently incurable skin disease. Skin Food’ is the first book to bring evidence-based nutrition to the management of common skin conditions, separating fact from fiction. It is easy to read and has been reviewed by a team of dietitians for scientific accuracy. Therefore it is not only ideal for healthcare professionals, but also members of the general public who would like to gain a greater understanding of the impact of nutrition on skin health. Through running a busy dermatology clinic in London, the author became aware that questions around diet – for example, “does what I eat affect my skin”, “should I exclude dairy or gluten” – were frequently raised by patients, yet rarely covered in training or textbooks on dermatology. She set about learning more about the link between diet and skin to support both patients and colleagues. Building on pioneering research into the powerful links between the gut microbiome and the skin, Dr Thivi's unique approach prioritises skin health while also helping you to feel great along the way. SkinFood will also explore the importance of the mind-body connection and its vital role in supporting our skin, as well as offer advice on how to develop a bespoke skincare routine that includes ingredients that work for you.Nutrition and dietetics guidance is a priority for patients with psoriasis however, such resources are at present limited. Icen M, Crowson CS, McEvoy MT et al. Trends in incidence of adultonset psoriasis over three decades: a population-based study. At present, limited evidence-based guidance on diet and nutrition exists for psoriasis patients and their families. The Mediterranean diet is one of the most highly studied dietary patterns, and has consistently demonstrated utility in reducing the incidence of major cardiovascular events in high-risk individuals when compared with a low-fat diet. 8 The traditional Mediterranean diet is characterised by a high intake of olive oil, fruit, nuts, vegetables and cereals, a moderate intake of fish and poultry and a low intake of dairy, red meat, processed meats and refined sugars. 9 Observational studies have identified low levels of adherence to a Mediterranean diet in patients with severe psoriasis; olive oil and fish consumption are independently predictive for PASI (Psoriasis Activity and Severity Index) and C-reactive protein levels. 10,11 The authors of these studies attribute the Mediterranean diet’s ability to reduce chronic systemic inflammation to the anti-inflammatory properties of dietary fibres, antioxidants and polyphenols that are rich in this pattern of eating. Ford AR, Siegel M, Bagel J, et al. Dietary Recommendations for Adults With Psoriasis or Psoriatic Arthritis From the Medical Board of the National Psoriasis Foundation: A Systematic Review. JAMA Dermatol. 2018;154(8):934–950

As for the writing, I wasn’t impressed either. Several things stroke me as odd, in a not pleasant way. While the author clearly has a special fondness for alliteration (“savior”/”slayer”, “divine”/”dark”, “deliver”/”destroy”, all in the same sentence, and some more in the next one), there are also plain repetitions like “drink drink after drink”, which made me cringe. Alliterations are good, but moderation is key. Where’s the hate, then? I mean, these are the first words of the synopsis, there is a quote about hate surviving after death but that’s it. The first idea given to the reader about the book is not spoken about in said book. Just… ???? I enjoyed reading about the characters as well. They were diverse, cross-cultural, and well-presented in depth, which is surprising for such a short book, and their actions in the face of such chaos are more than believable.

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Studies have shown that weight loss in people with psoriasis who are overweight or obese can result in significant improvements in the severity of their skin condition. Psoriasis is a common chronic inflammatory skin condition that can have an enormous impact on quality of life. Affected individuals develop red, itchy and painful plaques on their skin with overlying scales that can cause both discomfort and shame. Medical management of psoriasis includes topical treatments such as vitamin D and steroid-based creams and ointments, light therapy and immunosuppressive medications such as methotrexate and ciclosporin. Over the last two decades, numerous biologic therapies have also been developed to treat psoriasis.

Mahil, S., McSweeney, S., Kloczko, E., McGowan, B., Barker, J. and Smith, C. (2019), Does weight loss reduce the severity and incidence of psoriasis or psoriatic arthritis? A Critically Appraised Topic. Br J Dermatol, 181: 946-953 Our Skin Food range intensively nourishes dry skin with the power of nature. Natural oils and extracts from certified organic plants protect and nourish dry skin, leaving your body and face naturally soothed.

Knowledge booster

Steiner had developed a philosophy in the early 20th century called Anthroposophy, which observes that there is a spiritual world accessible to humans. According to the International Federation of Anthroposophic Medical Associations, the practice “is an integrative approach to treatment that extends and enhances health outcomes by looking outside of isolated symptoms toward a more holistic conception of health. This conception includes physical, psychological, and spiritual health, as well as the impact of a person's environment and social context.” Weleda is the original green beauty brand and world’s No.1 producer of certified natural skincare and holistic healthcare products, organically growing plants and creating natural health and beauty products in harmony with nature and human beings since 1921. Weleda has set the standard for ethical business, and its commitment to sustainability is recognised in B Corp certification and UEBT certification for sourcing with respect. Dr Thivi studied Medicine at Oxford University and completed Dermatology training in London. She undertook a PhD to understand the links between our skin and internal health and this research featured in top tier scientific journals such as Nature Communications and in international press. She is one of a handful of dermatologists to have completed training in severe eczema and psoriasis during a fellowship at St John’s Institute of Dermatology, London and achieved a Certificate in Nutrition Science from Stanford Medical School, USA. During her career, Dr Thivi has garnered over 15 academic awards, scholarships and prizes from organisations such as the British Association of Dermatologists, the British Society for Dermatology Research and the Royal Society of Medicine. Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes 2012; 2:e54