Air pollution exposure may trigger psoriasis flares
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Short-term air pollution exposure can increase the likelihood of psoriasis flares, according to a study.
“Environmental air pollution is defined by the World Health Organization (WHO) as the contamination of the ambient air by any chemical, physical or biological agent that modifies the natural characteristic of the atmosphere,” Francesco Bellinato, MD, of the section of dermatology and venereology at the University of Verona in Verona, Italy, and colleagues wrote. “Psoriasis is a chronic inflammatory disease with a relapsing-remitting course and selected environmental factors such as infections and/or drugs may trigger disease flares. Whether air pollution could trigger psoriasis flares is not known.”
Researchers conducted a case-crossover and cross-sectional, observational, retrospective study of 957 chronic plaque psoriasis patients.
Subjects had 4,398 follow-up visits and more than 15,000 air pollutant measurements.
Air pollutant concentrations were significantly higher in the 60 days before psoriasis flares for the 369 patients in the case-crossover analysis. This population included subjects with at least two consecutive visits, one psoriasis flare and a continuous systemic treatment for at least 6 months.
A median psoriasis area and severity index (PASI) score at the flare visit was 12 (interquartile range, 9-18), compared with PASI 1 at the control visit.
For the cross-sectional analysis, an air pollution or course particulate matter (PM) concentration were positively associated with an increase in PASI scores.
PASI scores of 5 or higher were more likely for those who had exposure to mean PM10 over 20 g/m3 (adjusted OR = 1.55; 95% CI, 1.21-1.99) and mean PM 2.5 over 15 g/m3 (aOR = 1.25; 95% CI, 1-1.57) in the 60 days before visits.
“Short-term air pollution exposure is associated with increased psoriasis activity and likelihood of having a psoriasis flare,” the authors wrote. “Further study is needed to examine whether these findings generalize to other populations and to better understand the mechanisms by which air pollution may affect psoriasis disease activity.”