Incidence and Risk Factors for Psoriasis in the General Population

Abstract

To study the clinical spectrum of psoriasis and the incidence in the general population and to identify risk factors associated with the occurrence of psoriasis.Design: Prospective cohort study with nested casecontrol analysis. Setting:The data source was the United Kingdom General Practice Research Database containing computerized clinical information entered by general practitioners (GPs). Patients:The study population comprised patients receiving a first-ever diagnosis of psoriasis between January 1, 1996, and December 31, 1997, and free of cancer.Interventions: Diagnosis of psoriasis was validated in a random sample of 14% of all ascertained cases requesting confirmation by the GPs. Nested case-control analysis included 3994 cases of psoriasis and a random sample of 10 000 controls frequency matched to cases by age, sex, and calendar year.Main Outcome Measures: Incidence rate of psoriasis and estimates of the odds ratio (OR) and 95% confi-dence interval (CI) for psoriasis as associated with selected risk factors. Results:The incidence rate of psoriasis was 14 per 10 000 person-years. Patients with antecedents of skin disorders and skin infection within the last year carried the highest risk of developing psoriasis (OR, 3.6 [95% CI, 3.2-4.1], and OR, 2.1 [95% CI, 1.8-2.4], respectively). Also, smoking was found to be an independent risk factors for psoriasis (OR, 1.4 [95% CI, 1.3-1.6]). We did not find an association between risk of psoriasis and antecedents of stress, diabetes, hypertension, hyperlipidemia, cardiovascular disease, or rheumatoid arthritis. Conclusions:The incidence rate in our study was higher than those published in other studies, probably owing to our case definition that considered cases recorded by the GPs independently of a specialist confirmation. Our results confirm the association between psoriasis, skin disorders, and smoking.

Psoriasis and Vascular Disease—Risk Factors and Outcomes: A Systematic Review of the Literature

“…High quality publications found smoking to be an independent risk factor for psoriasis, with risk of psoriasis higher in exsmokers and current smokers than never smokers. 58,59 A marked dose-response relationship exists; the risk for development of psoriasis is highest for people smoking more than 20 cigarettes/day. 60 A similar dose-response relationship was confirmed for those smoking more than 15 cigarettes/day.…”

“…They also had a higher prevalence of hypertriglyceridemia and abdominal obesity, whereas hyperglycemia, HTN, and HDL levels were similar. Although psoriasis patients were more frequently smokers, the association of psoriasis with metabolic syndrome was independent from smoking 7 of 9 58 …”

Epidemiology and treatment of psoriasis: a Chinese perspective

“…57 A Spanish study reported a group of young subjects (21-40 years) who had upper respiratory tract infections before onset of psoriasis. 58 Some Chinese studies have shown similar findings. 9,12,17 Infection is the most common trigger for childhood psoriasis, which is consistent with the findings of Wu et al and Chiam et al regarding Chinese, Dutch, and Singaporean psoriasis studies.…”

Management of Psoriasis in Children: a Narrative Review

“…The disease affects 4% of all children younger than 16 years with all types of dermatologic disorders (2)(3)(4). The onset of disease in one third of all patients in childhood is in the first and second decades of life and there is a strong association between early onset of disease and HLA-Cw6 (5).…”

“…The onset of disease in girls is earlier than boys (7,8). Psoriasis is a chronic cell mediated inflammatory disease characterized by keratinocyte hyperproliferation, vascular endothelial proliferation and inflammatory cell infiltration of dermis and epidermis, with many of pathogenic mechanisms not fully cleared yet (1)(2)(3)(4). Several factors are contributed as causative agents of disease including genetic, environmental and immunologic factors (9).…”