Most dermatologists appreciate that psoriasis is a chronic, systemic, inflammatory disorder, multifactorial in etiology, with a complex interplay between genetic predisposition and environmental and behavioral factors (such as alcohol intake, obesity, and smoking). Behavioral factors appear to play a role in the development of psoriasis as well as affect the clinical severity of disease.1,2 As such, the awareness and ascertainment of these risk factors would be an important aspect of psoriasis management. Herein lies the practice gap for most dermatologists: Inattention to alcohol and smoking behaviors precludes the opportunity for their modification (by reduction or even cessation).
Shelling ML, Kirsner RS. Failure to Counsel Patients With Psoriasis to Decrease Alcohol Consumption (and Smoking)Comment on “Alcohol Intake and Risk of Incident Psoriasis in US Women”. Arch Dermatol. 2010;146(12):1370. doi:10.1001/archdermatol.2010.373