Linked article: Iskandar et al. Br J Dermatol 2021; 185:952-960. This UK-based study was set up to understand what factors can influence the results of treatment among patients with psoriasis. Previous work has indicated that there is a link between bad psoriasis and alcohol consumption, and this study was designed to identify any connection between alcohol consumption and the response to treatment. The group studied were patients attending clinics in England. All had moderate to severe psoriasis and were treated with the topical or oral therapies in common use (conventional therapies) but some had received the newer biologic treatments. All patients completed a questionnaire that included questions on the patients' self-estimate of misuse of alcohol as well as the severity of their psoriasis, which was recorded at various timepoints during treatment. Their information was recorded in a national database. Alcohol misuse and obesity were both associated with poorer responses to treatment with the conventional therapies. In addition, failure to stick to treatment schedules was also associated with poor results. At least 40% of those in this study reported psychological distress. The authors argue that providing advice on lifestyle and screening for alcohol misuse should form an important part of treatment of psoriasis.
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