A case-control study of 110 consecutive psoriatic outpatients and 200 unmatched controls was carried out in order to analyze the association of psoriasis with smoking habits, alcohol consumption, family history of psoriasis and stressful life events. Stressful life events were assessed with Paykel's Interview for Recent Life Events, a semi-structured interview covering 63 life events. According to our results, the risk of psoriasis is higher in urban dwellers (odds ratio [OR] = 3.61; 95% confidence interval [CI] = 0.99-13.18), patients who were divorced (OR = 5.69; 95% CI = 2.26-14.34) and those exposed to environmental tobacco smoke at home (OR = 2.29; 95% CI = 1.12-4.67). Alcohol consumption (OR = 2.55; 95% CI = 1.26-5.17), family history of psoriasis (OR = 33.96; 95% CI = 14.14-81.57) and change in work conditions (OR = 8.34; 95% CI = 1.86-37.43) are also risk factors for psoriasis. Separate analyses for men and women showed that the risk of developing psoriasis was stronger in men with a family history of psoriasis (OR = 30.39; 95% CI = 6.72-137.42) than in women (OR = 16.99; 95% CI = 7.21-40.07). The effect of environmental tobacco smoke at home was found only in women (OR = 2.44; 95% CI = 1.26-4.73). Future well-designed epidemiological studies need to be performed in order to determine whether lifestyle factors and stress could be risk factors triggering or aggravating psoriasis.

The aim of this study was to assess the role of stressful life events, lack of social support and attachment insecurity in triggering exacerbations of psoriasis. Outpatients experiencing exacerbation of psoriasis in the last 6 months (n = 110) were compared with outpatients affected by skin conditions in which psychosomatic factors are believed to play a minor role (n = 200). Stressful life events during the last 12 months were assessed with Paykel's Interview for Recent Life Events. Perceived social support and attachment relationship were assessed with the Multidimensional Scale of Perceived Social Support and Experiences in Close Relationships Scale, respectively. In comparison with controls the patients with psoriasis reported more stressful life events in the last year. The statistically significant difference was found only for the sum of the first 25 events (odds ratio (OR) 1.98; 95% confidence interval (CI) 1.37-2.87; p < 0.001). Also, patients with psoriasis were more likely to score higher on both anxiety (OR = 1.44; CI = 1.09-1.92; p = 0.011) and avoidance attachment scale (OR = 1.49; CI = 1.04-2.14; p = 0.030), and perceived less support from their social network than did the comparison subjects. The results of this study confirm the relevance of psychosocial factors in psoriasis.

Psoriasis patients have poorer HRQoL than the general population. This study supports the decision to use both generic and skin-specific instruments to assess the impact of psoriasis on HRQoL.

AbstractThe aim of the present case-control study was to assess the risk factors for Basal cell carcinoma (BCC) in the Montenegrin population. The study group was comprised of 100 consecutive patients with a diagnosis of BCC, while the control group consisted of patients who did not present skin cancer and who were individually matched to the cases by sex and age. The increased risk for BCC was associated with: the presence of nevi (odds ratio [OR] = 3.77; 95% confidence interval [CI] = 1.12–12.73), type of skin concerning to burn rather than to tan after repeated sun exposure in childhood or adolescence (OR = 3.14; 95% CI = 1.59–6.18), the skin reaction to burn after two or more hours of sunlight during childhood or adolescence (OR = 4.53; 95% CI = 2.37–8.63), the number of severe and painful sunburns during their lifetime(OR = 3.52; 95% CI = 1.68–7.38), outdoor work during the summer-time (OR = 2.73; 95% CI = 1.00–7.45), occupational exposure to chemicals (OR = 17.89; 95% CI = 2.82–113.52), history of eczema (OR = 4.17; 95% CI = 1.53–11.39), and history of previous BCC (OR = 3.86; 95% CI = 1.40–10.65). Our study confirms the role of environmental and constitutional factors in development of BCC.