Smoking and Psoriasis

Shahrad M. Behnam, BS; Shahdad E. Behnam, MD; John Y. Koo, MD


Skinmed. 2005;4(3):174-176. 

In This Article

Abstract and Introduction

Many early studies examining the relationship between tobacco and the development of plaque type psoriasis suggested a significant positive correlation; however, the majority of these initial studies failed to control for alcohol consumption and presented inconsistent results. The objective of this manuscript is to perform a literature review of articles assessing the relationship between smoking and psoriasis while controlling for confounders such as alcohol consumption. Alcohol-controlled studies suggest that women who are smokers have an up to 3.3-fold increased risk of developing plaque-type psoriasis. Men who are smokers do not exhibit such an increased risk, but studies have shown that smoking more than 10 cigarettes per day by men who are psoriasis patients may be associated with a more severe expression of disease in their extremities. In addition, smoking among both men and women who are psoriasis patients has been shown to reduce improvement rates. These data demonstrate the importance of discouraging smoking, particularly among psoriasis patients.

There have been multiple attempts to understand the correlation between smoking and psoriasis. Initial epidemiologic and case-control studies showed a two- to three-fold increased prevalence of psoriasis among smokers[1,2,3,4,5]; however, the majority of these studies did not control for alcohol consumption,[2,3,4,5,6] which may by itself serve as a significant confounder.[4,7,8,9] As studies have begun to control for alcohol consumption, a consistent pattern has emerged. The goal of this paper is to assess the relationship between smoking and psoriasis among men and women while controlling for alcohol consumption. There will be a brief overview of the initial studies followed by a more detailed analysis of recent studies.


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