Pack-year cigarette smoking affects the course of palmoplantar pustulosis

Abstract

Background. Palmoplantar pustulosis (PPP) is a chronic inflammatory disease with poorly understood pathogenesis. The disease has a chronic course with improvements and exacerbations. Due to palmoplantar location, PPP has a severely negative impact on patients' quality of life.Objectives. To identify demographic and environmental factors, concomitant diseases, medications, and bacterial factors which may affect the course of PPP. Materials and methods.A total of 51 patients suffering from PPP took part in the study. They were classified according to the Palmoplantar Pustulosis Psoriasis Area and Severity Index (ppPASI) into 3 groups due to the severity of the disease. Pack-year of smoking score was established as a quotient of packets smoked every 24 h and the years of being addicted. Diagnosis of metabolic syndrome was based on the IDF criteria from 2009. Chlamydia trachomatis was detected using enzyme-linked immunosorbent assay (ELISA) technique, Staphylococcus aureus by the culture swabs. Contact hypersensitivity was examined with the T.R.U.E. test.Results. Significantly high severity of PPP was observed in patients addicted to smoking with a high pack-year score (p = 0.03). Significantly lower intensity of PPP lesions was observed in patients treated with ibuprofen (p < 0.01). There was no correlation between severity of PPP skin lesions and comorbidities.Conclusions. Addiction to cigarette smoking and a high pack-year score aggravates the course of PPP. Treatment with ibuprofen can improve the course of the disease.

Palmoplantar Pustulosis: A Systematic Review of Risk Factors and Therapies

“…The duration and amount of smoking influence the risk and disease severity. 7 , 16 , 101 , 103 Quitting smoking leads to a clinical improvement of PPP (p=0.007) and improves treatment efficacy. 9 , 104 …”

“…These include increased IgA antibodies against gliadin, moderate to severe anxiety (p<0.001), dysbiosis of the oral biota, infections of the oral cavity (mainly the tonsils), thyroid disease, metabolic syndrome, arthritis (such as pustulotic arthro-osteitis or psoriatic arthritis), and PV. 18,84,[92][93][94][95][96][97][98][99][100][101] PPP has also been identified as a predictor for the development of psoriatic arthritis in patients with psoriasis. 102 However, some authors separate palmoplantar pustular psoriasis from palmoplantar pustulosis in cases of psoriatic features such as plaques, generalized pustules, psoriatic arthritis, or a positive family history of psoriasis.…”

“…The duration and amount of smoking influence the risk and disease severity. 7,16,101,103 Quitting smoking leads to a clinical improvement of PPP (p=0.007) and improves treatment efficacy. 9,104 The pathomechanism regarding smoking is not fully understood, but the following factors have been considered.…”

Impact of cigarette smoking on fluorescence lifetime of ocular fundus

“…During the analysis, the smoker group was further divided into two groups based on the „pack-year”, defined as (packs smoked per day) × (years as a smoker). This value is widely used as a measure of cumulative cigarette intake 24 . For this purpose, the obtained median value of the pack-year among the smokers was used as a basis for dividing the group.…”

Letter to the Editor Regarding: Spesolimab Efficacy and Safety in Patients with Moderate-to-Severe Palmoplantar Pustulosis: A Multicentre, Double-Blind, Randomised, Placebo-Controlled, Phase IIb, Dose-Finding Study

“…Third, we know that smoking affects PPP. In a 51-patient study reported by Putra-Szczepaniak et al, the severity of PPP was higher in patients who were addicted to smoking and who smoked pack-years [ 6 ]. Thus, it is known that smoking is a factor that can influence the efficacy of the drug, but Burden et al [ 1 ] did not specify the smoking status of the patients.…”