Priority 13 from the Psoriasis PSP

UNCERTAINTY: Are lifestyle factors such as diet, alcohol intake, weight change and smoking involved in causing psoriasis?  (JLA PSP Priority 13)
Overall ranking 13
JLA question ID 0072/13
Explanatory note Not available for this PSP

Armstrong, 2014 Evidence of an association between smoking and incidence of psoriasis, with a possible dose-effect of smoking intensity and duration on psoriasis incidence.  This review suggested that smoking is an independent risk factor for the development of psoriasis, and that patients with established psoriasis continue to smoke more than patients without psoriasis.  More studies needed

Aune, 2018 Evidence that adiposity as measured by BMI, waist circumference, waist-to-hip ratio, and weight gain is associated with increased risk of psoriasis.  Further research needed.

Brenaut Evidence that alcohol consumption is greater in psoriasis patients than in the general population.  However, there is not enough evidence to establish whether alcohol consumption is a risk factor for psoriasis.  More research needed.

Richer, 2016 Evidence for a positive association between the prevalence of smoking and psoriasis as well as an association between smoking and severity of psoriasis.  Further research required. Fleming Increased severity of psoriasis appears to be associated with increased BMI. Most studies were cross-sectional or case-control, making it difficult to determine temporality.  Further studies needed. 

Versini 2014 Evidence that obesity worsens the course of, and impairs the treatment response of psoriasis, PsA (and other autoimmune diseases).  Extensive clinical data and experimental models demonstrate the involvement of adipokines in the pathogenesis of these autoimmune diseases.  Obesity appears to be a major environmental factor contributing to the onset and progression of autoimmune diseases.  More studies needed. 

Zheng, 2018 Evidence that intense physical activity may lower the prevalence of psoriasis.  Further research needed.

Health Research Classification System category Skin
Extra information provided by this PSP
Original uncertainty examples What is the connection between nicotine and psoriasis?
Submitted by 91 uncertainties were submitted around this question
PSP information
PSP unique ID 0072
PSP name Psoriasis
Total number of uncertainties identified by this PSP. 55  (To see a full list of all uncertainties identified, please see the detailed spreadsheet held on the JLA website)
Date of priority setting workshop 17 September 2018