It is common knowledge that patients with severe psoriasis have a premature mortality rate compared to the general population, even those with less severe disease.  The origins have typically been unclear, but past studies have associated excess alcohol intake, mental disorders, and various types of cancers with the problem (1).

A recent study, Alcohol-Related Mortality in Patients with Psoriasis: A Population-Based Cohort Study, published in JAMA Dermatology, investigated the increased risk of premature mortality in all psoriasis patients, regardless of severity.  The study concluded that a key contributor to the premature mortality gap may likely be due to alcohol-related causes (2); only a few previous studies have examined the possibility of alcohol-related deaths in psoriasis patients.

Using electronic medical records, data was collected from 1998 through 2014.  The study compared 55,537 adult psoriasis patients (> 18yrs) with 854,314 adult patients without psoriasis.  Of the large sample group, the average age was 47 years with men comprising 44.9% of the group and women 55.1%.

The study discovered that there is an approximately 60% greater risk of psoriasis patients dying due to alcohol-related causes when compared to the general population with the same demographics. The alcohol-related mortality rate was 4.8 per 10,000 person-years for the psoriasis group versus 2.5 per 10,000 for the non-psoriasis group.  The main causes of alcohol-related deaths were alcoholic liver disease (65.1%), fibrosis and cirrhosis of the liver (23.7%), and mental and behavioral disorders due to alcohol (7.9%).

According to the authors of the study, as many as one-third of psoriasis patients with moderate-to-severe psoriasis consume alcohol in excessive amounts.  The amount they drink in excess is directly correlated with their affected body surface area (BSA).  The psychological effects of living with psoriasis can be as detrimental as the condition itself, often leading sufferers to alcohol dependency.  It appears that alcohol abuse in psoriasis patients often goes unidentified by physicians and is ultimately under-treated.    In conclusion, physicians should consider screening alcohol consumption and misuse among people diagnosed with psoriasis.

 

References:

  1. Neimann AL, Porter SB, Gelfand JM. Epidemiology of psoriasis. Expert Rev Dermatol. 2006;1(1):63-75.
  2. Parisi R, Webb RT, Carr MJ, Moriarty KJ, Kleyn CE, Griffiths CEM, Ashcroft DM. Alcohol-Related Mortality in Patients With PsoriasisA Population-Based Cohort Study. JAMA Dermatol. 2017;153(12):1256–1262. doi:10.1001/jamadermatol.2017.3225