Clinical and Laboratory Investigations

Medical History, Drug Exposure and the Risk of Psoriasis
Evidence from an Italian Case-Control Study
Luigi Naldi^a, Liliane Chatenoud^b, Anna Belloni^g, Andrea Peserico^g, Nicola Balato^g, Anna Rosa Virgili^h, Pier Luigi Bruniⁱ, Vito Ingordo^j, Giovanni Lo Scocco^k, Carmen Solaroli^l, Donatella Schena^m, Anna Di Landro^a, Enrico Pezzarossaⁿ, Fabio Arcangeli^o, Claudia Gianni^c, Roberto Betti^d, Paolo Carli^{p, †}, Alessandro Farris^q, Gian Franco Barabino^r, Carlo La Vecchia^{b, e}, Fabio Parazzini<sup>f

a</sup>Centro Studi GISED, Ospedali Riuniti di Bergamo, Bergamo,
^bIstituto di Ricerche Farmacologiche Mario Negri,
^cDipartimento di Dermatologia, Ospedale San Raffaele,
^dClinica Dermatologica, Ospedale San Paolo,
^eIstituto di Statistica Medica e Biometria G.A. Maccacaro, Università degli Studi di Milano, e
^fClinica Mangiagalli, Policlinico Mangiagalli Regina Elena, Università di Milano, Milano,
^gClinica Dermatologica, Università di Padova, Padova,
^hClinica Dermatologica, Università di Ferrara, Ferrara,
ⁱClinica Dermatologica, Università di Terni, Terni,
^jOspedale Principale Militare di Taranto, Taranto,
^kUO Dermatologia, Azienda USL 4, Prato,
^lClinica Dermatologica, Università di Torino, Torino,
^mClinica Dermatologica, Università di Verona, Verona,
ⁿUO Dermatologia, Ospedale di Cremona, Cremona,
^oUO Dermatologia, Ospedale Bufalini, Cesena,
^pClinica Dermatologica, Università di Firenze, Firenze,
^qUO Dermatologia, Ospedale di Savona, Savona, e
^rUO Dermatologia, Dipartimento di Scienza della Salute, Università di Genova, Genova, Italy

Address of Corresponding Author

Dermatology 2008;216:125-132 (DOI: 10.1159/000111509)

  Key Words

• Psoriasis, comorbidity
• Drug exposure
• Risk factors
• Case-control study

  Abstract

Background/Aims: To evaluate the association of psoriasis with selected medical conditions and a number of drugs used before diagnosis. Methods: Multicenter case-control study involving outpatient services of 20 general and teaching hospitals. Entry criteria for cases were a first diagnosis of psoriasis made by a dermatologist and a history of skin manifestations of no more than 2 years after the reported onset of the disease. Controls were the first eligible dermatological patients observed on randomly selected days in the same centers as cases. A total of 560 cases and 690 controls were recruited. Results: The odds ratio (OR) of psoriasis was 0.8 (95% confidence interval, CI, 0.5-1.3) in hypertensive subjects, 1.1 (95% CI 0.6-2.0) in diabetics and 1.1 (95% CI 0.7-1.7) in hyperlipidemic subjects. Histamine 2 receptor antagonist exposure was negatively associated with psoriasis: OR 0.3 (95% CI 0.1-0.8). Conclusion: Our study rules out a strong association of psoriasis at its first ever diagnosis with common chronic conditions. The reported associations of psoriasis with relatively common conditions such as diabetes mellitus, hypertension and hyperlipidemia may represent a late effect of well-known risk factors for psoriasis such as smoking and overweight or reflect factors related to the long course of psoriasis itself.

Copyright © 2008 S. Karger AG, Basel

  Author Contacts

Dr. Luigi Naldi
Centro Studi GISED, Ospedali Riuniti
Largo Barozzi 1
IT-24100 Bergamo (Italy)
Tel. +39 035 400 625, Fax +39 035 269 603, E-Mail luigi.naldi@gised.it

  Article Information

Received: April 16, 2007
Accepted: July 18, 2007
Published online: January 23, 2008
Number of Print Pages : 8
Number of Figures : 0, Number of Tables : 3, Number of References : 26