On June 20, 2018, the Medical Board of the National Psoriasis Foundation published new dietary recommendations for adults with psoriasis in JAMA Dermatology.
Based upon strong evidence covered in this systematic review, the board recommends a hypocaloric diet (i.e., consuming fewer calories than are expended) in overweight and obese patients with psoriasis to reduce disease severity and the impact of psoriasis on quality of life.
Weaker evidence suggests a 90-day gluten-free trial period may be beneficial for some patients with psoriasis. Celiac disease is found at a more than 2-fold greater frequency in patients with psoriasis than in those without psoriatic disease. Psoriasis patients with positive blood markers for celiac disease were found to have significant improvements in symptom severity and skin biopsy findings after 3 months on a gluten-free diet.
Due to the high rate of false positives for celiac disease blood markers among psoriasis patients, the board does not currently recommend celiac disease screening for all psoriasis patients. Good candidates for celiac disease screening include those with active gastrointestinal symptoms or first-degree relatives with celiac disease.
For patients with psoriatic arthritis, the evidence remains unclear whether a gluten-free diet can reduce disease severity.