Metabolic syndrome (MetS) is now a global epidemic, causing a significant increase in the cost of healthcare, apart from deteriorating the quality of life. Skin acts as a mirror of underlying metabolic threats. Various dermatological conditions like psoriasis, acanthosis nigricans, lichen planus, acne vulgaris, acrochordons, atopic dermatitis, etc. have been explained to be associated with MetS. 

The most widely accepted theory for the pathogenesis of MetS is visceral obesity serving as the primary trigger causing insulin resistance and chronic inflammation, the main performers in the initiation and progress of the disease process.

Dermatoses associated with metabolic syndrome

The cascade of inflammatory changes associated with MetS remains similar for certain dermatoses. Thus, any pathophysiological dysfunction in metabolic parameters in the body may lead to skin diseases and vice versa. Certain dermatoses have a very strong association with MetS and hence, can act as a cutaneous marker of the latter. 

The connection to atopic dermatitis remains unclear but is found in a significant number of patients. Acanthosis nigricans and insulin resistance are closely related to MetS due to obvious pathophysiological similarities, while acne and androgenetic alopecia may have similar susceptibilities. Hence dermatologists examining these disorders must look for the markers of MetS in susceptible patients.

Source: Fatima F, Das A, Kumar P, et al. Skin and metabolic syndrome: an evidence based comprehensive review. Indian J Dermatol. 2021;66(3):302-7.