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Two related papers (ref. 12 and 13) from the same research group based on data resources of the Rochester Epidemiology Project in the Olmsted County, Minnesota. Validated CASPAR criteria were used for the diagnosis of psoriatic arthritis. The two studies document a trend toward increasing incidence of both psoriasis and psoriatic arthritis from January 1970 to December 1999. The annual incidence rate of psoriasis almost doubled during the study period
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•• Wilson FC, Icen M, Crowson CS, McEvoy MT, Gabriel SE, Kremers HM. Time trends in epidemiology and characteristics of psoriatic arthritis over three decades: A population-based study. J Rheumatol. 2009; 36: 361-7. Two related papers (ref. 12 and 13) from the same research group based on data resources of the Rochester Epidemiology Project in the Olmsted County, Minnesota. Validated CASPAR criteria were used for the diagnosis of psoriatic arthritis. The two studies document a trend toward increasing incidence of both psoriasis and psoriatic arthritis from January 1970 to December 1999. The annual incidence rate of psoriasis almost doubled during the study period.
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A prospective cohort study with nested case-control analysis using the U.K. General Practice Research Database containing computerized clinical information entered by general practitioners. The incidence rate of psoriasis was 14 per 10,000 person-year. Patients with antecedents of skin disorders and skin infection within the last year had the highest risk of developing psoriasis (misclassified prodromal signs of psoriasis?). Also, smoking was found to be an independent risk factor. No association was documented with antecedents of stress, diabetes, hypertension, hyperlipidemia, cardiovascular disease, or rheumatoid arthritis
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•• Setty AR, Curhan G, Choi HK. Smoking and the risk of psoriasis in women: Nurses' Health Study II. Am J Med. 2007; 120: 953-9. The Nurses' Health Studies are among the largest and longest running investigations of factors that influence women's health. Started in 1976 and expanded in 1989, information has provided by about 238, 000 dedicated nurse-participants (http://www. channing. harvard. edu/nhs/). The relationship between smoking status (including duration, intensity, cessation, and exposure to secondhand smoke) and incident psoriasis was examined during a 14-year time period (1991-2005). The primary outcome was incident, self-reported, physician-diagnosed psoriasis.
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The study presents a combined analysis of three cohorts: a cohort of older women (the Nurses' Health Study, 1996-2008), a cohort of younger women (the Nurses' Health Study II, 1991-2005), and a cohort of men (Health Professionals' Follow-up Study, 1986-2006). A total of 185,836 participants (2,410 with incident psoriasis) were included. Information on smoking was collected biennially during follow-up. The relative risk of incident psoriasis was 1.94 (95 % CI: 1.64, 2.28) for current smokers. There was a graded reduction of risk with an increase in time since smoking cessation
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This paper presents evidence that polymorphisms in the IL13/IL4 region may associate with protection from developing psoriatic arthritis and that this effect is abrogated by smoking. It is unclear from the data presented whether smoking per se associated with psoriatic arthritis
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• Ozden MG, Tekin NS, Gürer MA, et al. Environmental risk factors in pediatric psoriasis: a multicenter case-control study. Pediatr Dermatol. 2011; 28: 306-12. A multicenter, case-control study of 537 patients with psoriasis and 511 controls younger than age 18 years. Overall, patients more frequently reported exposure to environmental tobacco smoke at home (OR 2. 9) and stressful life events in the year preceding the diagnosis than controls (OR 2. 9). In addition, children with psoriasis were more likely to have a higher BMI (> 26) than controls (OR = 2. 5).
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A study in 943 volunteering patients with dermatologist-diagnosed psoriasis enrolled in the Utah Psoriasis Initiative (2002-2008). BMI at age 18 years was predictive of psoriatic arthritis. Koebner phenomenon and nail involvement were also associated with psoriatic arthritis
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A cohort study using data from The Health Improvement Network, a medical records database representative of the UK general population, collected between 1995 and 2010. The exposure of interest was the first BMI measured after psoriasis diagnosis and endpoints were incident cases of physician-diagnosed psoriatic arthritis. Among 75,395 individuals with psoriasis, 976 developed psoriatic arthritis (incidence rate, 26.5 per 10,000 person-years). The incidence rates increased with increasing BMI
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•• Love TJ, Zhu Y, Zhang Y, Wall-Burns L, Ogdie A, Gelfand JM, et al. Obesity and the risk of psoriatic arthritis: a population-based study. Ann Rheum Dis. 2012; 71: 1273-7. A cohort study using data from The Health Improvement Network, a medical records database representative of the UK general population, collected between 1995 and 2010. The exposure of interest was the first BMI measured after psoriasis diagnosis and endpoints were incident cases of physician-diagnosed psoriatic arthritis. Among 75, 395 individuals with psoriasis, 976 developed psoriatic arthritis (incidence rate, 26. 5 per 10, 000 person-years). The incidence rates increased with increasing BMI.
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A case-control analysis using data from the UK General Practice Research Database. A total of 36,702 incident cases of psoriasis and the same number of matched controls were identified. Long-term use of lithium was associated with a small increase in risk of incident psoriasis (ORs of 1.68). There was a suggestion of a possible reduced psoriasis risk associated with the use of atypical antipsychotics, mainly olanzapine
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•• Brauchli YB, Jick SS, Curtin F, Meier CR. Lithium, antipsychotics, and risk of psoriasis. J Clin Psychopharmacol. 2009; 29: 134-40. A case-control analysis using data from the UK General Practice Research Database. A total of 36, 702 incident cases of psoriasis and the same number of matched controls were identified. Long-term use of lithium was associated with a small increase in risk of incident psoriasis (ORs of 1. 68). There was a suggestion of a possible reduced psoriasis risk associated with the use of atypical antipsychotics, mainly olanzapine.
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