Association between smoking and the severity of psoriasis

ABSTRACT

Introduction: Smoking is a risk factor for development of psoriasis. The severity of psoriasis has also been associated with smoking. Smoking may be an important modifiable factor in psoriasis treatment. Reduction or cessation of smoking in psoriasis patients is relevant as psoriasis is also associated with cardiovascular disease. Objectives: This study aims to determine the association between smoking and severity of psoriasis, and to investigate the frequency of concomitant cardiovascular risk factors in our psoriasis patients. Method: A 6-month prospective, controlled study. Consecutive patients with chronic plaque psoriasis attending Dermatology Clinic, Kuala Lumpur Hospital were screened. Smokers were identified, age, gender and ethnic matched non-smokers were recruited. Patients were evaluated for Psoriasis Severity Index (PASI) and body surface area (BSA) affected by psoriasis. Results: A total of 89 chronic plaque psoriasis patients were screened. Twenty four smokers and 24 matched non-smokers were included in the study. There were no significant differences in the presence of medical co-morbidities, blood pressure, body mass index (BMI), age of psoriasis onset and duration of disease in both groups. The mean age patients started smoking was 20.2±5.6 years, the mean duration of smoking was 16.3±11.1 years, the number of cigarette per day 11.9±6.1 sticks and the number of cigarette pack years was 10.7±9.2. BSA affected by psoriasis and PASI score were significantly higher in the subjects who smoked compared to the non smokers. Conclusion: Smoking is associated with more severe psoriasis in terms of BSA and PASI. Cardiovascular risk factors are common in psoriasis patients. These patients (smokers and non-smokers) require interventions to reduce their cardiovascular risks.