Smoking Linked to Higher Rate of Psoriasis: Study

FRIDAY, March 2 (HealthDay News) — Smokers are at higher risk of
developing the autoimmune skin condition psoriasis than nonsmokers, a new
study finds, possibly because smoking pushes the body’s immune system into
overdrive, one expert suggests.

The research doesn’t directly prove that smoking causes psoriasis, and
the wide majority of smokers would avoid developing the condition even if
they faced an increased risk.

Still, the findings provide yet another reason for smokers to drop the
habit, said study co-author Dr. Abrar Qureshi, an assistant professor of
dermatology at Harvard Medical School. “It behooves us even more to advise
individuals who are smoking to quit,” he said, especially because
psoriasis itself is linked to higher risks of diabetes and heart attacks.

Psoriasis, which tends to occur in adulthood, causes itchy and painful
patches of thick, scaly and reddened or whitened skin. The patches often
appear on the knees and elbows.

The condition appears when the immune system mistakenly attacks skin
cells. Treatments are available, but they may not keep psoriasis at bay
forever.

Dermatologists have wondered whether smoking makes psoriasis worse,
Qureshi said. In the new study, investigators examined research projects
that followed more than 185,000 medical professionals in the United States
for as long as two decades. They looked specifically at 2,410 people who’d
been diagnosed with psoriasis.

After adjusting their statistics so they wouldn’t be thrown off by high
or low numbers of people who were overweight or had other risk factors for
psoriasis, the researchers found that current smokers were about 1.9 times
more likely to have psoriasis than nonsmokers. Past smokers were nearly
1.4 times more likely to have the condition.

The study found a “graded reduction of risk” as time passed after a
participant had quit smoking.

The study didn’t calculate the actual percentages of smokers,
nonsmokers and past smokers who developed psoriasis. However, Qureshi said
about 2 percent to 3 percent of the general population has the condition.

It’s possible that something other than smoking boosts the risk of
psoriasis in smokers, Qureshi said. It would be unethical to confirm that
smoking is the cause because that would require researchers to randomly
assign some people to smoke, he said.

Even if researchers could confirm that smoking causes or worsens the
condition, the question would remain how it might do so. Qureshi said that
while it’s possible that simply being around smoke could hurt the skin
externally, “there are a number of autoimmune conditions that are
exacerbated and caused by inhaled smoke.”

Dr. Joel Gelfand, medical director of the University of Pennsylvania’s
department of dermatology clinical studies unit, said that “since
psoriasis is an inflammatory disease, it is plausible that smoking lights
the fire that leads to chronic inflammation of psoriasis in people who are
susceptible.”

Gelfand, who’s familiar with the study results, said the research
confirms previous findings.

“Importantly, the investigators showed that the risk of psoriasis
increased with the amount of smoking and a reduction in risk of psoriasis
was observed with an increase in time from when people quit smoking,” he
said. “Smoking is common among patients with psoriasis and extremely
common among patients with a variant of psoriasis called ‘palmar-plantar
pustular psoriasis,’ which can be severely disabling.”

Smoking has already been associated with aging and wrinkling of the
skin, Gelfand said. Psoriasis, he added, “is another reason to quit.”

The study appears in a recent issue of the American Journal of
Epidemiology
.

More information

For more about psoriasis, visit the U.S. National Library of
Medicine.

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