Abstract
Background
Psoriasis impairs the quality of life of approximately 7.5 million Americans and is
associated with serious comorbidities. Because of chronic vascular access and epidermal
dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater
risk for infection, and psoriasis treatment could affect this risk.
Methods
A retrospective cohort analysis was performed using the United States Renal Data System
from 2004-2011 to investigate the association of psoriasis with infections common
to ESRD patients, as well as the effect of psoriasis treatment on infection risk as
well as mortality.
Results
A total of 8,911 psoriasis patients were identified. Psoriasis was associated with
a significantly increased risk for all queried infections, especially cellulitis (adjusted
relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis
treatment (systemic, local, and light) was associated with a significantly decreased
risk of some infections. Psoriasis treatment was also correlated with a significantly
decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants)
showing the greatest reduction (adjusted hazard ratio = 0.55).
Conclusions
These results suggest that psoriasis-ESRD patients may have an increased risk of infection
and treatment of psoriasis is associated with a reduced risk of some infections and
improved survival.
Keywords
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Article info
Publication history
Published online: March 29, 2021
Accepted:
March 25,
2021
Received:
September 11,
2020
Identification
Copyright
Published by Elsevier Inc. on behalf of Southern Society for Clinical Investigation.
