title: Severity of Psoriasis Among Adult Males is Associated with Smoking, Not with Alcohol Use.
abstract: BACKGROUND
  Lifestyle factors such as tobacco smoking and alcohol use can affect the presentation and course of psoriasis. There is a paucity of data on this subject from India.
  
  
  OBJECTIVE
  To find out whether increased severity of psoriasis in adult Indian males is associated with tobacco smoking and alcohol use.
  
  
  METHODS
  Cross-sectional study in the Department of Dermatology of a Tertiary Care Teaching Hospital.
  
  
  METHODS
  Male patients above 18 years of age attending a psoriasis clinic between March 2007 and May 2009 were studied. Severity of psoriasis (measured using Psoriasis Area and Severity Index - PASI) among smokers and non-smokers was compared. We also studied the correlation between severity of psoriasis and nicotine dependence (measured using Fagerström Test for Nicotine Dependence) and alcohol use disorders (measured using Alcohol Use Disorders Identification Test-AUDIT).
  
  
  METHODS
  Z-test, Odd's ratio, Chi-square test, Spearman's correlation coefficient.
  
  
  RESULTS
  Of a total of 338 patients, 148 were smokers and 173 used to consume alcohol. Mean PASI score of smokers was more than that of non-smokers (Z-test, z = -2.617, P = 0.009). Those with severe psoriasis were more likely to be smokers (χ(2) = 5.47, P = 0.02, OR = 1.8, Confidence Interval 1.09-2.962). There was a significant correlation between PASI scores and Fagerström score (Spearman's correlation coefficient = 0.164, P < 0.01). Mean PASI scores of persons who used to consume alcohol and those who did not were comparable.(Z-test, z = -0.458, P = 0.647). There was no association between severity of psoriasis and alcohol consumption.(χ(2) = 0.255, P = 0.613, Odds Ratio = 1.14, CI 0.696-1.866). There was no correlation between PASI scores and AUDIT scores (Spearman's correlation coefficient = 0.024, P > 0.05).
  
  
  CONCLUSIONS
  Increased severity of psoriasis among adult males is associated with tobacco smoking, but not with alcohol use.
authors.affiliation: Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India.
authors.forename: N
authors.initials: N
authors.lastname: Asokan
authors.affiliation: Department of Dermatology and Venereology, Government Medical College, Thrissur, Kerala, India.
authors.forename: Priya
authors.initials: P
authors.lastname: Prathap
authors.affiliation: Department of Psychiatry, Government Medical College, Thrissur, Kerala, India.
authors.forename: Pp
authors.initials: P
authors.lastname: Rejani
keywords: Alcohol drinking; psoriasis; severity; smoking