Environmental Factors Associated With Psoriatic Arthritis in Patients With Psoriasis

Physically demanding occupational tasks (eg, lifting heavy loads) and infections that required antibiotics are associated with psoriatic arthritis (PsA) in patients with psoriasis. There is an inverse association between cigarette smoking and PsA.

Eder and coworkers conducted a case-control study of patients with recent-onset PsA and patients with psoriasis but not arthritis (controls). They investigated a broad range of potential triggering factors and designed a questionnaire for assessing these exposures, which included physical trauma, infections, vaccinations to hepatitis A and B, emotional stress, female hormonal exposures, occupational exposures, smoking status, and alcohol consumption.

The proportion of smokers was lower in the PsA group than in the psoriasis group. Lifting cumulative loads of at least 100 lb/h was more common in the PsA group. A history of infectious diarrhea in the exposure time window under study was more common in the PsA group. After multivariate logistic regression, lifting cumulative loads of at least 100 lb/h, infections that required antibiotics, smoking, and injuries remained significantly associated with PsA. No association was found between PsA and alcohol consumption, vaccination, emotional stress, and female hormonal exposures.

The authors noted that their results need to be confirmed by a prospective study among patients with psoriasis.


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