Cover image of the thesis, by Jeanette Engqvist, Illumedic AB.

Marta Laskowski: Self-assessment and risk factors for psoriasis


Psoriasis stands as one of the most prevalent chronic diseases. In her doctoral thesis, Marta Laskowski explores how poor fitness and low stress resilience in youth elevate the risk of this inflammatory skin condition. She has also translated and validated a self-assessment tool, potentially enhancing remote evaluations of psoriasis patients in Sweden.

Marta Laskowski, a resident physician in dermatology and venereology at Sahlgrenska University Hospital and doctoral student at the Institute of Clinical Sciences.

Dissertation defense: 24 May 2024 (click for details)
Doctoral thesis: Psoriasis: prognostic factors and self-assessment
Research area: Dermatology and Venereology
Sahlgrenska Academy, The Institute of Clinical Sciences

Psoriasis isn’t just a skin condition, but also linked to other health issues such as obesity, cardiovascular disease, and depression. Conditions like cardiovascular disease are influenced by poor fitness levels, while stress affects depression.

“Stress is also considered a contributing factor to psoriasis exacerbation. Bariatric surgery proves effective in achieving weight loss and, according to some studies, can both improve and worsen psoriasis symptoms,” explains Marta Laskowski, a resident physician in dermatology and venereology at Sahlgrenska University Hospital and a doctoral candidate at the Institute of Clinical Sciences.

She continues, “While healthcare visits are partially digital nowadays, there haven’t been any effective Swedish-language self-assessment tools for psoriasis. This complicates remote evaluations.”

Evaluating risk factors

Could you summarize your thesis?
“Our research, using Swedish registries, examines whether poor physical fitness and low stress resilience in youth correlate with a higher risk of psoriasis later in life. We also investigate whether bariatric surgery affects psoriasis symptoms among patients with moderate to severe psoriasis. Finally, we’ve translated a psoriasis self-assessment tool from English to Swedish and validated it against the current healthcare provider-dependent evaluation tool.”

Figure 6, page 37 in the thesis. Cardiorespiratory fitness and psoriasis. One of the studies in Marta Laskowski’s doctoral thesis shows an association between low cardiorespiratory fitness (CRF) levels in adolescence and new-onset psoriasis.

Easing remote assessment

What are the key research findings and their practical implications?
“Our studies reveal that both low fitness levels and low stress resilience in late adolescence are associated with an increased risk of psoriasis later in life. The thesis confirms that bariatric surgery is effective in terms of weight loss among well-treated psoriasis patients. However, surgery doesn’t seem to result in either improvement or worsening of psoriasis symptoms in this patient group,” says Marta Laskowski, adding:

“Furthermore, we prove that our translated version of the self-assessment tool is reliable and provides the same information as an in-person visit with healthcare professional assessment. Our hope is that these findings will further clarify the relationships between psoriasis and its associated conditions, ease remote assessments of psoriasis, and strengthen patient involvement in psoriasis follow-ups.”

Figure 2, page 18 in the thesis. There is a strong association between obesity and psoriasis. One study in the thesis showed no effect of bariatric surgery on psoriasis symptoms in systemically, and successfully, treated patients.

“Rapid development”

What has been enjoyable and rewarding about your doctoral project?
“The rapid development of knowledge and treatment methods within inflammatory skin diseases, particularly psoriasis, is incredibly exciting. We’ve transitioned from viewing psoriasis solely as a skin condition to adopting a more holistic perspective. Additionally, we’re in an era of digitization that poses new challenges for healthcare. Conducting research on psoriasis in this dynamic time has been very gratifying.”

Text: Jakob Lundberg

Illustrations: Jeanette Engqvist, Illumedic