Cigarette smoking and short-term treatment responsiveness of moderate to severe psoriasis

Abstract

Cigarette smoking is a risk factor for psoriasis but little is known about the relationship between cigarette smoking and treatment outcome. We examined the relationship between cigarette smoking and treatment outcome among a cohort of 92 consecutive consenting inpatients. There were 47 men and 45 women, age 46.7±15.3 years (mean±SD), duration of psoriasis 18.9±13.8 years and total body surface area (TBSA) affected by psoriasis 60.1±24.9%. All patients received standard inpatient therapies consisting of anthralin, tar topical corticosteroids and UVB light therapy. The duration of inpatient stay was 23.1±14.5 days. Clinical assessments were carried out within the first week of admission and within 2 days before discharge from the inpatient service. The patients were not restricted from smoking cigarettes during their inpatient stay. Treatment outcome was defined as the difference in measures of psoriasis severity, i.e. TBSA affected by psoriasis, and the severity of scaling, erythema, plaque thickness, overall lesional severity and pruritus severity, between pretherapy and posttherapy. The possible confounding effect of alcohol use was controlled for statistically by analysis of covariance (ANCOVA). There were no differences (at P±0.05) by ANCOVA in the pretherapy psoriasis severity ratings or treatment outcome among the three cigarette smoking-related groups of ‘none’, ‘one to ten’ and ‘more than ten’ cigarettes smoked daily, over the 6 months prior to admission. The changes in TBSA affected in the three smoking-related groups were 26.0±22.6%, 20.5±19.8% and 21.9±29.6%, respectively (P=NS). Cigarette smoking did not have a measurable effect on short-term treatment outcome among patients with moderate to severe plaque-type psoriasis.

Key Words:

• Cigarette smoking
• Psoriasis
• Treatment outcome