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      Alcohol and Psoriasis for the Dermatologist: Know, Screen, Intervene

      research-article
      Author(s): 1 , 2 , 1 , 2 , 3 ,
      Publication date (Electronic):
      Journal: American Journal of Clinical Dermatology
      Publisher: Springer International Publishing

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          Abstract

          Psoriasis patients are at increased risk of harmful alcohol use and alcohol dependency with many deleterious effects. Increasing alcohol use is associated with worsening psoriasis severity, is a risk factor for poor response to systemic treatments and may impact on comorbidities such as psoriatic arthritis, cardiovascular disease, cancer and liver disease. Harmful alcohol use and alcohol dependency can be defined by the updated ICD-11 coding system and screening can be completed using many tools including the Cut down, Annoyed, Guilty, Eye-Opener (CAGE), Alcohol Use Disorders Identification Test (AUDIT) and Michigan Alcohol Screening Test (MAST) questionnaires. Dermatologists may be able to complete brief interventions encouraging alcohol reduction in psoriasis patients. Psoriasis patients may respond to messages of gain with reduced psoriasis severity and loss with reduced cardiovascular risk. It is important for dermatologists to discuss alcohol with all psoriasis patients, to be aware of the impact of alcohol in psoriasis and to familiarise themselves with screening tools, brief intervention and local services available to patients who require specialist input for harmful alcohol use or alcohol dependency.

          Supplementary Information

          The online version contains supplementary material available at 10.1007/s40257-022-00713-z.

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          Most cited references53

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          Pathogenesis and clinical features of psoriasis.

          Christopher EM Griffiths, Jonathan Barker (2007)
          Psoriasis, a papulosquamous skin disease, was originally thought of as a disorder primarily of epidermal keratinocytes, but is now recognised as one of the commonest immune-mediated disorders. Tumour necrosis factor alpha, dendritic cells, and T-cells all contribute substantially to its pathogenesis. In early-onset psoriasis (beginning before age 40 years), carriage of HLA-Cw6 and environmental triggers, such as beta-haemolytic streptococcal infections, are major determinants of disease expression. Moreover, at least nine chromosomal psoriasis susceptibility loci have been identified. Several clinical phenotypes of psoriasis are recognised, with chronic plaque (psoriasis vulgaris) accounting for 90% of cases. Comorbidities of psoriasis are attracting interest, and include impairment of quality of life and associated depressive illness, cardiovascular disease, and a seronegative arthritis known as psoriatic arthritis. A more complete understanding of underlying pathomechanisms is leading to new treatments, which will be discussed in the second part of this Series.
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            Psoriasis

            Christopher Griffiths, April W. Armstrong, Johann Gudjonsson … (2021)
            Psoriasis is a common, chronic papulosquamous skin disease occurring worldwide, presenting at any age, and leading to a substantial burden for individuals and society. It is associated with several important medical conditions, including depression, psoriatic arthritis, and cardiometabolic syndrome. Its most common form, chronic plaque or psoriasis vulgaris, is a consequence of genetic susceptibility, particularly in the presence of the HLA-C*06:02 risk allele, and of environmental triggers such as streptococcal infection, stress, smoking, obesity, and alcohol consumption. There are several phenotypes and research has separated pustular from chronic plaque forms. Immunological and genetic studies have identified IL-17 and IL-23 as key drivers of psoriasis pathogenesis. Immune targeting of these cytokines and of TNFα by biological therapies has revolutionised the care of severe chronic plaque disease. Psoriasis cannot currently be cured, but management should aim to minimise physical and psychological harm by treating patients early in the disease process, identifying and preventing associated multimorbidity, instilling lifestyle modifications, and employing a personalised approach to treatment.
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              The Michigan alcoholism screening test: the quest for a new diagnostic instrument.

              M L Selzer (1971)
              Article 0 comments Cited 372 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Brian Kirby:
                ORCID: http://orcid.org/0000-0001-7596-892X
                bkirby@svhg.ie
                Journal
                Journal ID (nlm-ta): Am J Clin Dermatol
                Journal ID (iso-abbrev): Am J Clin Dermatol
                Title: American Journal of Clinical Dermatology
                Publisher: Springer International Publishing (Cham )
                ISSN (Print): 1175-0561
                ISSN (Electronic): 1179-1888
                Publication date (Electronic): 23 August 2022
                Publication date PMC-release: 23 August 2022
                Publication date (Print): 2022
                Volume: 23
                Issue: 6
                Pages: 881-890
                Affiliations
                [1 ]GRID grid.412751.4, ISNI 0000 0001 0315 8143, Department of Dermatology, , St. Vincent’s University Hospital Dublin, ; Dublin, Ireland
                [2 ]GRID grid.7886.1, ISNI 0000 0001 0768 2743, School of Medicine, , University College Dublin, ; Dublin, Ireland
                [3 ]GRID grid.7886.1, ISNI 0000 0001 0768 2743, Charles Institute of Dermatology, , University College Dublin, ; Dublin, Ireland
                Author information
                http://orcid.org/0000-0002-6469-3462
                http://orcid.org/0000-0001-7596-892X
                Article
                Publisher ID: 713
                DOI: 10.1007/s40257-022-00713-z
                PMC ID: 9576661
                PubMed ID: 35997945
                SO-VID: d0d1d1ad-26a4-4753-9fa0-51c023ef6615
                Copyright © © The Author(s) 2022
                License:

                Open AccessThis article is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License, which permits any non-commercial use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by-nc/4.0/.

                History
                Date accepted : 16 July 2022
                Funding
                Funded by: The City of Dublin Skin and Cancer Hospital Charity
                Funded by: University College Dublin
                Open Access :

                Open Access funding provided by the IReL Consortium

                Categories
                Subject: Therapy in Practice
                Custom metadata
                issue-copyright-statement © Springer Nature Switzerland AG 2022

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