Reexamining the Role of Diet in Dermatology

The document discusses the increasing interest in the role of diet in dermatology, with almost 3000 articles published on the topic in the last decade. It highlights the ketogenic diet, which is high in fat, low to moderate in protein, and very low in carbohydrates. The diet has been suggested to have beneficial effects on skin disease due to its impact on insulin and androgen levels, which could potentially help conditions like acne vulgaris and hidradenitis suppurativa. The ketogenic diet has also been used as a dietary strategy for weight loss, which could be beneficial for skin conditions associated with obesity and metabolic syndrome, such as psoriasis, hidradenitis suppurativa, and androgenetic alopecia. However, the document emphasizes that robust clinical studies on ketogenic diets in skin disease are lacking. A recent trial observed benefit in all 37 overweight patients with chronic plaque psoriasis who underwent a ketogenic weight loss protocol, but it's unclear if the diet or the weight loss was the main driver of improvement. The ketogenic diet may also have anti-inflammatory and antioxidant effects, which could be beneficial for patients with keratinocyte carcinomas. However, more data is needed before it can be recommended for all cancer patients.