PracticeUpdate: Dermatology - Vol 1 - No.1 - 2017

MEDICAL DERMATOLOGY 19

Alcohol use disorders are common in patients with eczema and psoriasis The British Journal of Dermatology Take-home message

non-inflammatory disease (14.3%). Odds rati- os(OR) (95% CI) for AUDs in inflammatory groups compared with non-inflammatory, adjusted for age and gender were: psoriasis 1.65 (0.86–3.17), eczema 2.00 (1.03–3.85), lupus 1.03 (0.39–2.71), other inflammatory 1.32 (0.68–2.56). OR were reduced if also adjusted for DLQI. The preva- lence of DLQI of ≥11 was: psoriasis 31.1%, eczema 43.7%, cutaneous lupus 17.5%, other inflamma- tory 17.2% and non-inflammatory 2.8%. CONCLUSIONS Patients with eczema attending a single site hospital clinic have been shown to have high levels of alcohol use disorders of a similar level to patients with psoriasis and higher than patients with non-inflammatory skin dis- eases. The role of alcohol in the exacerbation of eczema needs further investigation. Cau- tion and a full alcohol history is recommended when treating eczema patients with potentially hepatotoxic medication. By identifying heavier drinking patients we may be able to support them with interventions to reduce alcohol intake and potentially improve their skin disease. High prevalence of alcohol use disorders in patients with inflammatory skin diseases. Br J Dermatol 2017 Mar 27;[EPub Ahead of Print], K Al-Jefri, D Newbury-Birch, CR Muirhead, et al.

• The authors of this observational, cross-sectional study evaluated the association between alcohol use disorders (AUD) and inflammatory skin diseases. They found that 24.5% of patients with inflammatory skin diseases had an AUD and that this was higher than the prevalence of AUD in the group without inflammatory skin lesions (14.3%). Eczema patients had the highest prevalence of AUD at 33.3%, followed by psoriasis patients (30.6%). • Eczema and psoriasis patients had high rates of AUD in this observational study.

Abstract BACKGROUND There is a known association between psoriasis and heavy alcohol consump- tion. Causality remains unclear with evidence supporting both alcohol triggering psoriasis and psoriasis predisposing to heavy alcohol con- sumption. However, the association between heavy alcohol consumption and other inflam- matory skin diseases remains to be defined. OBJECTIVE To examine the prevalence of heavy COMMENT By Robert T Brodell MD, FAAD T his article demonstrates that excessive alcohol ingestion is associated with both eczema and psoriasis. I could imagine that alcohol, like smoking, might aggravate these skin diseases. On the other hand, could it be that individuals with unsightly or pruritic conditions are driven to drink? Even more intriguing is a possible link to metabolic syndrome. Could there be biochemical reasons that impact the way alcohol is metabolised or alter its impact on the brain that increase the likelihood of excessive use? However the association is explained, we should consider adding a question about alco- hol use to our eczema and psoriasis intake forms so that proper counselling and referrals can be made as needed.

drinking using the Alcohol Use Disorders Identification Test (AUDIT) in patients with inflam- matory skin disease. METHODS We conducted an observational cross sectional study in a single hospital out-patient department. We recruited 609 patients in 5 groups; psoriasis, eczema, cutaneous lupus (lupus), other inflammatory disorders and a ref- erence population with skin lesions. The primary outcome was the proportion of patients in each group with an alcohol use disorder (AUD). RESULTS Observed prevalence of AUD was: pso- riasis (30.6%), eczema (33.3%), cutaneous lupus (12.3%), other inflammatory disease (21.8%) and

Dr Brodell is Professor and Chair of the Department of Dermatology, and Professor of Pathology at the University of Mississippi Medical Center,

Jackson, Mississippi. He is also Instructor in Dermatology at the University of Rochester School of Medicine and Dentistry in New York.

VOL. 1 • NO. 1 • 2017