CME article Journal of American Academy of Dermatology, December 2014

2. Learning Objective
To review influence of dietary factors in
management of:
 Melanoma
 Chronic urticaria
 Psoriasis

3. Melanoma
• Polyunsat FA are anti-inflammatory,UVP ,
proapoptotic & decrease tumor growth
• ↓Alcohol consumption → decreased UV-induced
DNA damage, decreased immunity, decreases
MSH and PG production
• Vit D is antiproliferative, proapoptotic &
decrease metastatic potential
• Vit E is anticarcinigenic, UVP&
immunomodulating

4. PUFAs

5. Contd.
 Selenium relieves UV induced
depletion of glutathione peroxidase
& proapoptotic
 Green tea polyphenols is anti-
inflammatory, immunomodulating,
anticarcinigenic UV photoprotective

6. Contd.
 Resveratrol is UV
photoprotective, antioxidant,
antiinflammatory &
anticarcinogenic
 Lycopene is UV
photoprotective, antioxidant
& decrease metastatic
diseases.

7. Melanoma (Interventional
studies)
 Vitamin D supplementation is of NO value
 Vitamin E is PROTECTIVE against high risk
melanoma
 Low alcohol consumption role is UNCLEAR
• Green tea, resveratrol & lycopene amay be
used as additional protective supplement
• PUFAs & selenium RCTs not conducted

8. Chronic Urticaria
 Pseudoallergen-free diet improves DLQI &
antiinflammatory
 Gluten-free diet is antiinflammatory, decreases
production of anti-IgE receptor antibodies
 Vitamin D improves Chronic urticaria

9. Chronic Urticaria
(Interventional studies)
 Gluten-free diet can be considered in celiac
disease pts
 Vitamin D supplement with appropriate dosage
is Recommended
 Pseudoallergen-free diet is Recommended to
chronic urticaria patients.

10. Pseudoallergen Free Diet
• Breads without preservatives
• Fresh Milk, yogurt,Butter & vegetable oils
• Semolina
• Potatoes, Rice
• Fresh meat
• Salt, Sugar
• Coffee & Black tea
• Egg free Noodles

11. Pseudoallergens
 Processed meat
 Eggs & fish
 Peas,mushrooms,tomatoes,spinach,olives
 All fruits
 Garlic, pepper, herbs and many condiments
 Sweetners and beverages

12. “Dietary Habits in Patients with
Chronic Spontaneous Urticaria:
Evaluation of Food as Trigger of
Symptoms Exacerbation”
Jorge Sánchez,Andres Sánchez, Ricardo Cardona
Dermatology Research and Practice
Volume 2018, Article ID 6703052

13. “Despite the high frequency of self-
report by patients, foods are
uncommon triggers of CSU.
Nevertheless, food challenge tests
have to be offered early during medical
evaluation to avoid unnecessary
restrictions.”

14. Psoriasis
• Weight loss increases efficay of some medicines
& improves DLQI & PASI
• Low alcohol intake decreases medication
toxicity, increases efficay & decreased anxiety,
depression & CVD.
• Gluten-free diet decreased production of tissue
transglutaminase & other celiac disease specific
antibodies

15. Contd.
• Oral vitamin D acts against CVD & metabolic
syndrome in Psoriasis pts
• PUFAs acts as antiinflammatory & decrease
medication toxicity
• Folic acid supplement acts as antithrombotic,
cardioprotective, improved DNA function, &
decreased methotrexate toxicity
• Selenium and other antioxidants ameliorate
symptoms

16. Psoriasis
(Interventional studies)
• Weight loss increases drug efficay and
decreases psoriasis symptoms
• Psoriasis pts tend to be more alcoholic, abuse
should be screened and discouraged
• Gluten-free diet decreases Psoriasis and
coeliac disease symptoms
• Insufficient data to support PUFA, Vit D and
anti oxidant supplementation