Purpose and Hypotheses The purpose of this study is to find out if changing the diet and adding exercise can help children with psoriasis. Psoriasis is a skin condition that causes red, scaly patches and is linked to inflammation inside the body. We want to see if a special diet that avoids gluten and foods high in histamine can improve children's skin and reduce inflammation. We will also test if adding a fun physical therapy program with light exercise, stretching, and relaxation provides even more benefits, especially for their overall well-being and quality of life.
Study Details:
Study Duration: 14 weeks in total (this includes a 2-week screening period and the 12-week treatment period).
Treatment Duration: 12 weeks.
Visit Frequency: Participants will come to the clinic for assessments at the start of the study, after 6 weeks, and after 12 weeks. During the 12-week treatment period, participants in the exercise group will attend supervised physical therapy sessions three times a week.
What Will Happen in the Study? Sixty (60) children aged 6 to 17 with mild to moderate psoriasis will be invited to take part. They will be put into one of three groups by chance, like drawing lots. One group will continue with their regular skin care. A second group will follow a special anti-inflammatory diet. This means they will avoid foods with gluten (like wheat bread) and foods high in histamine (like aged cheese or fermented foods) and will eat more fruits, vegetables, and healthy fish. A third group will follow the same diet and also take part in a physical therapy program three times a week. The physical therapy will include light exercise, fun movement activities, and relaxation exercises.
Who Can Participate?
We are looking for children who:
Have been diagnosed with plaque psoriasis for at least 6 months.
Have mild to moderate psoriasis.
Are not taking any new psoriasis medications.
Study Interventions:
Dietary Intervention: A structured anti-inflammatory diet that is gluten-free and low in histamine.
Physical Therapy: A supervised program of low-impact aerobic activities, stretching, and relaxation exercises.
This study is not currently available through an expanded access program.
Inclusion Criteria
Exclusion Criteria
Mahmoud_usama@cu.edu.eg+201285221209
The outcomes assessors (the dermatologist performing the P-PASI assessments and the laboratory technician analyzing blood samples) will be blinded to group allocation. Participants will be instructed not to discuss their intervention with the assessors. The treating physical therapist and dietitian cannot be blinded due to the nature of the interventions. The statistician will receive data coded by participant ID only, without group identifiers, for the primary analysis.
Participants in this group will continue their usual dermatologic care as prescribed by their treating physician. This includes standard topical treatments (e.g., corticosteroids, vitamin D analogues) or other stable systemic therapies. No dietary modifications or physical therapy interventions will be provided as part of the study protocol. Participants will attend clinic visits for assessments at baseline, 6 weeks, and 12 weeks.
Participants in this group will receive a 12-week structured anti-inflammatory diet that is gluten-free and low in histamine, designed by a registered pediatric dietitian. The diet eliminates all gluten sources (wheat, barley, rye, and contaminated oats) and restricts high-histamine foods (aged cheeses, fermented dairy products, cured meats, canned fish, spinach, tomatoes, eggplant, avocado, bananas, chocolate, and nuts). Participants are encouraged to consume fresh fruits, vegetables, lean proteins, omega-3-rich fish, olive oil, and gluten-free grains. For overweight or obese children, a mild energy restriction (250-500 kcal/day deficit) is included. Participants continue their usual dermatologic care. Dietary adherence is monitored via three-day food diaries and weekly adherence scales.
Participants in this group will receive the same 12-week anti-inflammatory diet (gluten-free, low-histamine) as described for Arm 2. In addition, they will participate in a 12-week structured physical therapy program consisting of 45-minute sessions, three times per week. Each session includes: a 10-minute warm-up (light walking or cycling), a 25-minute main component of low-impact aerobic activities (supervised swimming, adapted dance, or circuit training), and a 10-minute relaxation and breathing component (yoga poses, diaphragmatic breathing). Sessions are led by a pediatric physical therapist. Participants continue their usual dermatologic care.
Mediterranean Diet vs no Dietary Intervention for Improving Signs and Symptoms of Psoriasis in Patients Treated With Anti-IL-17 or Anti-IL-23 Inhibitors
Efficacy Study of Dietary Intervention and Weight Loss in Improving Psoriasis
The Role of Food Sensitivity in Psoriasis
Effect of Exercise and Diet on Psoriatic Arthritis
Use of Total-Body PET to Quantify Systemic and Cutaneous Inflammation in Psoriasis Patients Before and After Intervention With a Nutritionally Balanced Diet
Effectiveness of a Digital Health Application for Psoriasis
Study of the Effect of Diet in Overweight or Obese Patients With Psoriasis on Light Therapy
The Mediterranean Diet and Time-Restricted Eating Dietary Interventions for Psoriasis Study