Relationship between smoking and the clinical severity of psoriasis.
OBJECTIVE
To evaluate the association between different components of smoking history and the clinical severity of psoriasis.


METHODS
A hospital-based cross-sectional study.


METHODS
Inpatient wards of a hospital for skin diseases in Rome, Italy.


METHODS
A total of 818 adults with psoriasis.


METHODS
The Psoriasis Area and Severity Index was used to assess the clinical severity of psoriasis between February 21, 2000, and February 19, 2002.


RESULTS
After adjustment for potential confounders (sex, age, body mass index, psychological distress, family history of psoriasis, duration of psoriasis disease, and alcohol consumption), high intensity of smoking (>20 cigarettes daily) vs a lower level of consumption (< or =10 cigarettes daily) was associated with a more than 2-fold increased risk of clinically more severe psoriasis (odds ratio [OR], 2.2; 95% confidence interval [CI], 1.2-4.1). Cigarette-years, measured as the product of the intensity and duration (years) of smoking, significantly increased the risk of clinically more severe psoriasis after adjustment for confounding factors (OR,1.3; 95% CI, 1.0-1.6, for a 600-U increase in cigarette-years). Separate analyses for men and women showed that the effect of cigarette-years was stronger for women (OR, 1.8; 95% CI, 1.2-2.6, for a 400-U increase in cigarette-years) than for men (OR, 1.2; 95% CI, 0.9-1.6, for a 700-U increase in cigarette-years).


CONCLUSIONS
Smoking is associated with the clinical severity of psoriasis and highlights the importance of smoking cessation in patients with psoriasis.
Fortes
Cristina
C
Clinical Epidemiology Unit, Istituto Dermopatico dell'Immacolata, Istituto di Ricovero e Cura a Carattere Scientifico, Via dei Monti di Creta 104, 00167 Rome, Italy. c.fortes@idi.it
Mastroeni
Simona
S
Leffondré
Karen
K
Sampogna
Francesca
F
Melchi
Franco
F
Mazzotti
Eva
E
Pasquini
Paolo
P
Abeni
Damiano
D
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006761:Hospitals; D006801:Humans; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000209:etiology* / Q000473:pathology / Q000517:prevention & control; D012720:Severity of Illness Index; D012907:Smoking / Q000009:adverse effects*; D016540:Smoking Cessation; D011795:Surveys and Questionnaires