Alcohol Intake and Risk of Psoriasis in Women

Study using data from the Nurses’ Health Study II finds that consumption of non-light beer increases the risk of developing psoriasis in women.

Although the “association between alcohol consumption and increased risk of psoriasis onset and psoriasis worsening” that has long been suspected has been confirmed at least in part by case-control studies that have reported “a significant association between alcohol consumption and psoriasis,” the authors noted that studies have not shown a significant association between alcohol and psoriasis in women. Positing that if (as has been demonstrated by several studies) “certain types of alcoholic beverages have different effects on risk of psoriasis, then this fact would have practical implications for psoriasis prevention and management,” the authors of this paper undertook to evaluate “the association between total alcohol consumption and risk of incident psoriasis in a cohort of US women with no history of psoriasis” and explore “the association between type of alcoholic beverage and risk for incident psoriasis.”

Published in the December 2010 issue of Archives of Dermatology, this study analyzed data from the Nurses' Health Study II (NHS II), which is “an ongoing longitudinal study of 116,430 female registered nurses from 15 states in the United States who were between the ages of 25 and 42 years when they completed and returned a baseline questionnaire in 1989.” One of the questions NHS participants were asked to answer queried them on their frequency of intake of several types of alcoholic beverages. To identify the association between alcohol intake and psoriasis risk, the authors of the present study mailed the Psoriasis Screening Tool (PST) questionnaire to all NHS II participants who self-reported a physician diagnosis of psoriasis.

Over a 14-year follow-up period (involving 1,069 incident cases of psoriasis), the authors observed an increased age-adjusted relative risk (RR) of psoriasis in women who consumed more than 2.3 alcoholic beverages per week compared with nondrinkers, after adjusting for age, BMI, smoking status, and several other factors. They also found that “risk of psoriasis varied by type of alcoholic beverage” consumed, with women who drank five or more non-light beers per week experiencing a greater relative risk of psoriasis. However, women who “drank any amount of light beer, white wine, red wine, or liquor were not at increased risk of incident psoriasis.”

The authors reported that there were 1,150 incident cases of psoriasis (1,069 used for analysis) among the 2,430 women who received the PST (86% of whom were confirmed as having psoriasis). Among these confirmed cases, the authors “observed a materially elevated and statistically significant RR of psoriasis in women who consumed 2.3 or more alcoholic beverages per week and in women who drank 5 or more nonlight beers per week.”

In their comments on these findings, the authors reiterated that women who consumed five or more non-light beers per week faced a 2.3 times higher risk for psoriasis, independent of age, smoking, BMI, and other factors. Noting that only non-light beer consumption was associated with an increase in psoriasis risk, that authors speculated that this may be due to “certain nonalcoholic components of beer, which are not found in wine or liquor,” such as the gluten-containing starch sources used to make beer. However, they noted that “although a gluten-free diet helps clear psoriasis, it remains unknown whether gluten contributes to new-onset psoriasis and whether this only occurs in predisposed individuals, such as those with latent gluten sensitivity.”

The authors concluded that “women who drank at least 5 nonlight beers per week were 1.8 times more likely to develop psoriasis compared with women who abstained from alcohol. Lower intake of nonlight beer and intake of other types of alcoholic beverages do not appear to influence the risk of developing psoriasis. Women with a high risk of psoriasis may consider avoiding higher intake of nonlight beer.”