As for adult psoriasis, pediatric psoriasis has recently been associated with obesity, increased waist circumference percentiles, and waist-to-height ratios, and metabolic laboratory abnormalities1- 3 (eTable in Supplement). Although obesity could theoretically result from the functional limitations and psychosocial impact of psoriasis, adult females self-reported that obesity developed before psoriasis4 and high body mass index (BMI) (calculated as weight in kilograms divided by height in meters squared) in adolescent girls preceded psoriasis hospitalization in adults.5 To our knowledge, whether obesity precedes pediatric psoriasis or psoriasis leads to childhood obesity has not been addressed. In a pilot study with a new cohort, we addressed the temporal association of pediatric psoriasis and increased adiposity in 27 overweight and obese children with psoriasis.
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