Index > Vol. 85/2005 > Iss. 4/July > pp. 299-303 > Abstract
Letter to the Editor

Drug Exposure and Psoriasis Vulgaris: Case-Control and Case-Crossover Studies

doi: 10.1080/00015550510032823

Abstract:

Intake of drugs is considered a risk factor for psoriasis. The aim of this study was to investigate the association between drugs and psoriasis. A case-control study including 110 patients who were hospitalized for extensive psoriasis was performed. A control group (n = 515) was defined as patients who had undergone elective surgery. A case-crossover study included 98 patients with psoriasis. Exposure to drugs was assessed during a hazard period (3 months before hospitalization) and compared to a control period in the patient's past. Data on drug sales were extracted by data mining techniques. Multivariate analyses were performed by logistic regression and conditional logistic regression. In the case-control study, psoriasis was associated with benzodiazepines (OR 6.9), organic nitrates (OR 5.0), angiotensin-converting enzyme (ACE) inhibitors (OR 4.0) and non-steriodal anti-inflammatory drugs (NSAIDs) (OR 3.7). In the case-crossover study, psoriasis was associated with ACE inhibitors (OR 9.9), beta-blockers (OR 9.9), dipyrone (OR 4.9) and NSAIDs (OR 2.1). Extensive psoriasis may be associated with intake of ACE inhibitors, NSAIDs or beta-blockers.

Key words:

angiotensin-converting enzyme inhibitors, beta-blockers, drug reactions, non-steroidal anti-inflammatory drugs, psoriasis vulgaris

References:

  1. Abel, E. A. and DiCicco, L. M. and Orenberg, E. K. and Fraki, J. E. and Farber, E. M. (1986) Drugs in exacerbation of psoriasis. J Am Acad Dermatol, 15, pp. 1007 - 1022.
  2. Abel, E. A. (1992) Diagnosis of drug-induced psoriasis. Semin Dermatol, 11, pp. 269 - 274.
  3. Gold, M. H. and Holy, A. K. and Roenigk, H. H Jr. (1988) Beta-blocking drugs and psoriasis. A review of cutaneous side effects and retrospective analysis of their effects on psoriasis. J Am Acad Dermatol, 19, pp. 837 - 841.
  4. Tsankov, N. and Angelova, I. and Kazandjieva, J. (2000) Drug-induced psoriasis. Recognition and management. Am J Clin Dermatol, 1, pp. 159 - 165.
  5. Cohen, A. D. and Kagen, M. and Friger, M. and Halevy, S. (2001) Calcium channel blockers intake and psoriasis: a case-control study. Acta Derm Venereol, 81, pp. 347 - 349.
  6. Marshall, R. J. and Jackson, R. T. (1993) Analysis of case-crossover designs. Stat Med, 12, pp. 2333 - 2341.
  7. Marshall, R. J. and Wouters, S. and Jackson, R. T. (2000) A case-crossover analysis of a case-control study of alcohol consumption and coronary events: the effects of exposure definition and the use of control data. J Epidemiol Biostat, 5, pp. 367 - 373.
  8. Maclure, M. (1991) The case-crossover design: a method for studying transient effects on the risk of acute events. Am J Epidemiol, 133, pp. 144 - 153.
  9. Maclure, M. and Mittleman, M. A. (2000) Should we use a case-crossover design? Annu Rev Public Health, 21, pp. 193 - 221.
  10. Gilleaudeau, P. and Vallat, V. P. and Carter, D. M. and Gottlieb, A. B. (1993) Angiotensin-converting enzyme inhibitors as possible exacerbating drugs in psoriasis. J Am Acad Dermatol, 28, pp. 490 - 492.
  11. Wolf, R. and Dorfman, B. and Krakowski, A. (1987) Psoriasiform eruption induced by captopril and chlorthalidone. Cutis, 40, pp. 162 - 164.
  12. Ikai, K. (1995) Exacerbation and induction of psoriasis by angiotensin-converting enzyme inhibitors. J Am Acad Dermatol, 32, pp. 819.
  13. Tamir, A. and Wolf, R. and Brenner, S. (1994) Exacerbation and induction of psoriasis by angiotensin-converting enzyme inhibitors. J Am Acad Dermatol, 30, pp. 1045.
  14. Coulter, D. M. and Pillans, P. I. (1993) Angiotensin-converting enzyme inhibitors and psoriasis. N Z Med J, 106, pp. 392 - 393.
  15. Steinkraus, V. and Steinfath, M. and Mensing, H. (1992) Beta-adrenergic blocking drugs and psoriasis. J Am Acad Dermatol, 27, pp. 266 - 267.
  16. Halevy, S. and Livni, E. (1993) Beta-adrenergic blocking drugs and psoriasis: the role of an immunologic mechanism. J Am Acad Dermatol, 29, pp. 504 - 505.
  17. Halevy, S. and Livni, E. (1991) Psoriasis and psoriasiform eruptions associated with propranolol: the role of an immunological mechanism. Arch Dermatol Res, 283, pp. 472 - 473.
  18. Ferrier, M. C. and Souteyrand, P. (1992) Psoriasis and non steroidal anti-inflammatory agents. Ann Dermatol Venereol, 119, pp. 591 - 595.
  19. Powles, A. V. and Griffiths, C. E. and Seifert, M. H. and Fry, L. (1987) Exacerbation of psoriasis by indomethacin. Br J Dermatol, 117, pp. 799 - 800.
  20. Katayama, H. and Kawada, A. (1981) Exacerbation of psoriasis induced by indomethacin. J Dermatol, 8, pp. 323 - 327.
  21. Lazarova, A. Z. and Tsankov, N. K. and Zlatkov, N. B. (1989) Psoriasis induced by topically applied indomethacin. Clin Exp Dermatol, 14, pp. 260 - 261.
  22. Ascari-Raccagni, A. and Baldari, U. and Rossi, E. and Alessandrini, F. (2000) Exacerbation of chronic large plaque psoriasis associated with Olanzepine therapy. J Eur Acad Dermatol Venereol, 14, pp. 315 - 316.
  23. Katz, M. and Seidenbaum, M. and Weinrauch, L. (1987) Penicillin-induced generalized pustular psoriasis. J Am Acad Dermatol, 17, pp. 918 - 920.
  24. Sidoroff, A. and Halevy, S. and Bowes-Bavinck, J. N. and Vaillant, L. and Roujeau, J. C. (2001) Acute generalized exanthematous pustulosis (AGEP) – a clinical reaction pattern. J Cutan Pathol, 28, pp. 113 - 119.
  25. Koester, H. and Fikentscher, R. (1974) Beta-hemolysing streptococci invasion of the pharynx in exanthematic psoriasis. Dermatol Monatsschr, 160, pp. 650 - 653.