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Evidence remains unclear on alcohol as a risk factor for psoriasis

Although studies found that patients with psoriasis consumed more alcohol than the general population, there was not enough evidence to establish alcohol as a risk factor, according to results of a systematic review.

“Most of the studies conclude that alcohol consumption is higher in psoriasis patients than in the general population,” researcher Emilie Brenaut, MD, a dermatologist at University Hospital of Brest in Brest, France, told Healio.com. “However, it remains unclear whether alcohol represents a genuine risk factor or is merely a consequence of psoriasis.”

 

Emilie Brenaut

Brenaut and colleagues in France conducted a systematic literature search using Medline, Embase and Cochrane databases with keywords “psoriasis” and “alcohol drinking” or “alcohol-related disorders.” A second search was conducted with the keywords “psoriasis” and “risk factor” or “comorbidity.”

Nine hundred-eleven eligible articles in English and French were identified, of which 837 were excluded after researchers read the abstract or the article. Twenty-eight articles were selected for the study.

Eighteen of 23 articles concluded that psoriasis patients had higher alcohol consumption than the general population while five studies did not. Three studies that used a questionnaire or quantitative criteria to compare the prevalence of excessive drinking found that it was more prevalent among patients with psoriasis compared with the general population. Patients with psoriasis consumed more alcohol than controls in 11 studies. Four studies reported excessive alcohol consumption by patients with psoriasis without comparison to a control group.

“The heterogeneity in the measurement of alcohol did not allow performing meta-analysis,” the researchers reported.

Four of five studies came to the conclusion that alcohol was a risk factor for psoriasis.

“It is important to ask [about] alcohol consumption of patients with psoriasis, and help them to decrease for many reasons,” Brenaut said, “[including] it is possible that alcohol is a risk factor for psoriasis, systemic treatments [like methotrexate] can be forbidden by the liver abnormalities due to excessive drinking, and patients with psoriasis often have other comorbidities, especially cardiovascular.”

Disclosures: See the study for a full list of relevant financial disclosures.