Alcohol consumption and psoriatic risk: A meta‐analysis of case–control studies

Abstract

Psoriasis is one of the most common dermatological disorders. The association between alcohol consumption and psoriasis has been inconsistent among studies. To examine the magnitude of the risk of developing psoriasis for drinking populations compared to those with non-drinking, and to determine causes of the variation in odds ratios (OR) between various case-control studies, we performed a comprehensive published work search and a meta-analysis of case-control studies considering prevalence. We did electronic searches on Medline, and searched reports to identify case-control studies of prevalent of psoriasis. We did meta-analyses of study-specific incremental estimates to determine the risk of psoriasis associated with drinking. The magnitude of the OR was analyzed by combining 15 case-control studies that matched defined criteria. The variance in OR between studies was explored. The overall OR of psoriasis for drinking persons compared to those with non-drinking was 1.531 (95% confidence interval [CI] = 1.164-2.014, P = 0.002) and the association remains statistically significant across a number of stratified analyses in European descent subgroup (OR = 1.432, 95% CI = 1.085-1.889, P = 0.011) and also persists in sensitivity analyses performed to assess the potential effect of varying psoriasis outcome definitions. Alcohol consumption is associated with increased risk of psoriasis. These epidemiological observations should inform the exploration of biological mechanisms that link alcohol consumption with psoriasis.

Heterogeneity of Response to Biologic Treatment: Perspective for Psoriasis

“…Further investigation of the potential impact of these factors on treatment response in patients with psoriasis is warranted, especially as smoking may be an independent risk factor for psoriasis in both women and men (Li et al, 2012). Similarly, alcohol consumption (Zhu et al, 2012). In addition, examination of the impact of some of these factors in more diverse populations (e.g., elderly patients with comorbidities) and quantification of the prevalence of such factors in future studies may also help decision making in clinical practice.…”

Psoriasis: epidemiology, natural history, and differential diagnosis

“…Recently, a metaanalysis of case-control studies showed that the overall odds ratio of psoriasis for drinking persons compared to those with non-drinking habits was 1.531 (P = 0.002), suggesting that alcohol consumption is associated with an increased risk of psoriasis. 31 However, the connection between psoriasis and alcohol consumption remains complex and has yet to be fully elucidated. Several other studies have not shown a significant correlation between alcohol consumption and psoriasis.…”

“…16,20,32 Several mechanisms by which alcohol may induce psoriasis have been proposed, including upregulation of pro-inflammatory cytokines in various cell types, proliferation and activation of lymphocytes, hyperproliferation of keratinocytes as well as an increased risk of infection which can precipitate psoriasis. 31,[33][34][35] Acute bacterial and viral infections have been associated with the onset or exacerbation of psoriasis. 36,37 Streptococcal infections are often triggers of guttate psoriasis, especially in children and young adults.…”

Alcohol, Liver, Systemic Inflammation and Skin: A Focus on Patients with Psoriasis

“…Psoriasis in heavy drinkers tends to be more severe, more extensive and their lesions are usually more inflamed [7,8]. A number of case-control studies confirmed the association of psoriasis with alcohol abuse and recently a comprehensive meta-analysis of these published studies was also conducted showing a significant link between psoriatic risk and alcohol consumption in drinking versus non-drinking subjects [9]. Alcohol misuse is a major cause of both acute and chronic liver disease and TNF-α, a key cytokine in psoriasis pathogenesis, has been found to have a crucial role in this process [10,11].…”