Epidemiology of psoriasis.
31 May 2004-Current Drug Targets - Inflammation & Allergy (Curr Drug Targets Inflamm Allergy)-Vol. 3, Iss: 2, pp 121-128
TL;DR: By imposing methodologic control and a numerate approach, epidemiology can offer a major contribution to understand psoriasis.
Abstract: The prevalence of psoriasis is relatively high in the general population, ranging between 0.6% and 4.8%, mainly as a result of chronicity and the absence of a cure. Although genetic-environmental interaction has been proposed as a model for the causation of psoriasis, the evidence for environmental factors is rather scarce. Risk factors, which have been documented in epidemiological studies include smoking, alcohol consumption, diet, infection, drugs, and stressful life events. Psoriasis affects the quality of life to substantial degree. Apart from a few cross-sectional surveys of large series of psoriatic patients, there have been no formal studies of the natural history and prognosis of established psoriasis. By imposing methodologic control and a numerate approach, epidemiology can offer a major contribution to understand psoriasis.
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TL;DR: The data indicated that the occurrence of psoriasis varied according to age and geographic region, being more frequent in countries more distant from the equator and trends in incidence over time.
1,878 citations
Cites background from "Epidemiology of psoriasis."
...Despite a number of narrative reviews of the epidemiology of psoriasis (Farber and Nall, 1998; Plunkett and Marks, 1998; Christophers, 2001; Naldi, 2004; Neimann et al., 2006; Gudjonsson and Elder, 2007; Chandran and Raychaudhuri, 2010), a systematic review has not been performed....
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TL;DR: Findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries, and a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes.
Abstract: Aims As part of a larger study to estimate the global burden of disease and injury attributable to alcohol: to evaluate the evidence for a causal impact of average volume of alcohol consumption and pattern of drinking on diseases and injuries; to quantify relationships identified as causal based on published meta-analyses; to separate the impact on mortality versus morbidity where possible; and to assess the impact of the quality of alcohol on burden of disease. Methods Systematic literature reviews were used to identify alcohol-related diseases, birth complications and injuries using standard epidemiological criteria to determine causality. The extent of the risk relations was taken from meta-analyses. Results Evidence of a causal impact of average volume of alcohol consumption was found for the following major diseases: tuberculosis, mouth, nasopharynx, other pharynx and oropharynx cancer, oesophageal cancer, colon and rectum cancer, liver cancer, female breast cancer, diabetes mellitus, alcohol use disorders, unipolar depressive disorders, epilepsy, hypertensive heart disease, ischaemic heart disease (IHD), ischaemic and haemorrhagic stroke, conduction disorders and other dysrhythmias, lower respiratory infections (pneumonia), cirrhosis of the liver, preterm birth complications and fetal alcohol syndrome. Dose-response relationships could be quantified for all disease categories except for depressive disorders, with the relative risk increasing with increased level of alcohol consumption for most diseases. Both average volume and drinking pattern were linked causally to IHD, fetal alcohol syndrome and unintentional and intentional injuries. For IHD, ischaemic stroke and diabetes mellitus beneficial effects were observed for patterns of light to moderate drinking without heavy drinking occasions (as defined by 60+ g pure alcohol per day). For several disease and injury categories, the effects were stronger on mortality compared to morbidity. There was insufficient evidence to establish whether quality of alcohol had a major impact on disease burden. Conclusions Overall, these findings indicate that alcohol impacts many disease outcomes causally, both chronic and acute, and injuries. In addition, a pattern of heavy episodic drinking increases risk for some disease and all injury outcomes. Future studies need to address a number of methodological issues, especially the differential role of average volume versus drinking pattern, in order to obtain more accurate risk estimates and to understand more clearly the nature of alcohol-disease relationships.
1,034 citations
Cites result from "Epidemiology of psoriasis."
...In addition to the finding of a clear dose–response relationship [186– 188], the prevalence of psoriasis among alcoholics was between two and 10 times greater than in the general population [179,189–191]....
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TL;DR: Psoriasis is a common disease, occurring more frequently with advancing age, and the available prevalence data come from only 20 countries, meaning there are huge geographic gaps in knowledge, especially from low‐ and middle‐income settings.
Abstract: To inform the WHO Global report on psoriasis, a new comprehensive worldwide systematic review of the epidemiology of psoriasis was undertaken. The aim of this study was to systematically review the worldwide literature regarding the epidemiology of psoriasis, including prevalence and incidence, in adults and in children. A search of 15 electronic medical databases was performed. Using a rigorous systematic protocol, eligible articles were analysed. No language, regional or temporal restrictions were applied. A total of 76 study observations met all eligibility criteria and were included in the systematic review. The estimates of the prevalence of psoriasis in adults ranged from 0.51% to 11.43%, and in children from 0% to 1.37%. Psoriasis is a common disease, occurring more frequently with advancing age. Limited data on the epidemiology of psoriasis are available. The available prevalence data come from only 20 countries, meaning there are huge geographic gaps in knowledge, especially from low- and middle-income settings.
661 citations
TL;DR: Risks of psoriasis of recent onset with smoking habits, body mass index (BMI) and stressful life events were consistent with a multiplicative model of risk combination with no significant statistical interaction.
619 citations
Cites background from "Epidemiology of psoriasis."
...Smoking habits, alcohol consumption, diet, body mass index (BMI), stressful life events, and infections have been repeatedly considered as potentially important causative factors (Naldi, 2004)....
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TL;DR: Severe but not mild psoriasis is associated with an increased risk of death, and the association with mortality persisted after adjustment for risk factors for mortality.
Abstract: Objective To determine the risk of mortality in patients with psoriasis. Design Cohort study. Setting General practitioners participating in the General Practice Research Database in the United Kingdom, 1987-2002. Patients Mild psoriasis, defined as any patient with a diagnostic code of psoriasis but no history of systemic therapy; severe psoriasis, any patient with a diagnostic code of psoriasis and a history of systemic therapy consistent with severe psoriasis. The unexposed (control) population was composed of patients with no history of a psoriasis diagnostic code. Control patients were selected in a 5:1 ratio from the same practice and date in practice as the patients with psoriasis. Main Outcome Measure Hazard ratio (HR) of time to death using Cox proportional hazards models adjusted for age and sex. Results There was no overall effect of mild psoriasis on mortality (HR, 1.0; 95% confidence interval [CI], 0.97-1.02), whereas patients with severe psoriasis demonstrated an increased overall mortality risk (HR, 1.5; 95% CI, 1.3-1.7). The association of severe psoriasis with mortality persisted after adjustment for risk factors for mortality (HR, 1.4; 95% CI, 1.3-1.6) and after exclusion of patients with inflammatory arthropathy (HR, 1.5; 95% CI, 1.3-1.8). Male and female patients with severe psoriasis died 3.5 (95% CI, 1.2-5.8) and 4.4 (95% CI, 2.2-6.6) years younger, respectively, than patients without psoriasis (P Conclusion Severe but not mild psoriasis is associated with an increased risk of death.
503 citations
Cites background from "Epidemiology of psoriasis."
...In addition, psoriasis has been associated with excess alcohol intake, psychiatric disorders, and various types of internal malignant neoplasms such as lung, liver, pancreatic, breast, bladder, and kidney cancers, which could further explain the excess mortality observed in the severe psoriasis group.(4,30) Severe psoriasis itself can lead to death in very rare instances, as could cumulative drug toxicity...
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