Many factors might influence response to systemic treatment for moderate-to-severe psoriasis, which is generally, poorly understood. Thus there might be unidentified factors that may be relevant in determining response to treatment. 

Thus a study prospectively investigated if alcohol misuse is associated with poor response to treatment for psoriasis.

The Psoriasis Area and Severity Index (PASI) were utilized to assess the response to systemic therapies, and The CAGE (Cut down, Annoyed, Guilty, and Eye-opener) questionnaire was utilized to screen for alcohol misuse. 

The following observations were made-

• 266 patients were enrolled for the study.
• The median PASI improved from 13 at baseline to 3 during follow-up in the entire group of subjects. 
• A higher CAGE score; obesity and receiving a conventional systemic instead of a biologic therapy caused a poor response to treatment
• A higher baseline PASI demonstrated a better response to treatment.

Thus it was inferred that lifestyle behaviour change interventions and support are crucial along with routine clinical care in people with psoriasis having a deficient response to therapy, related to alcohol misuse and obesity. It can be addressed by targeting interventions to prevent, detect and manage alcohol misuse.

Source- BJD, 2021;185(5):952-960