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Updated: Mar 30, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis

Published on: July 11, 2013

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Antibiotic Exposure, Infection, and the Development of Pediatric Psoriasis: A Nested Case-Control Study

Daniel B Horton1, Frank I Scott2, Kevin Haynes3

  • 1Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia2Division of Rheumatology, Nemours A.I. duPont Hospital for Children, Thomas Jefferson University, Wilmington, Delaware3Rutgers Biomed.

JAMA Dermatology
|November 13, 2015
PubMed

Insights

Infections, particularly untreated ones, are linked to pediatric psoriasis development. However, antibiotic use showed only a weak association with new psoriasis cases in children.

Area of Science:

  • Dermatology
  • Pediatrics
  • Microbiology
  • Epidemiology

Background:

  • Antibiotics can disrupt the gut microbiome, potentially influencing autoimmune conditions in children.
  • Psoriasis activity in children has been previously associated with streptococcal and viral infections.

Purpose of the Study:

  • To investigate the independent associations between antibiotic exposure and infections with the incidence of pediatric psoriasis.
  • To differentiate the risk posed by infections versus antibiotic treatment in the context of childhood psoriasis.

Main Methods:

  • A nested case-control study utilized UK electronic health records (1994-2013).
  • 845 children with incident psoriasis were compared to 8450 age- and sex-matched controls.
  • Antibiotic prescriptions and infection diagnoses within two years prior to psoriasis diagnosis were analyzed using conditional logistic regression.

Main Results:

  • Infections of the skin (aOR, 1.5) and other sites (aOR, 1.3) were associated with incident pediatric psoriasis.
  • Untreated nonskin infections showed a significant association (aOR, 1.5), while antibiotic-treated nonskin infections did not (aOR, 1.1).
  • Antibiotic exposure demonstrated a weak association (aOR, 1.2) with incident psoriasis, with no significant links found for specific antibiotic classes or age of first exposure.

Conclusions:

  • Infections are associated with the development of pediatric psoriasis.
  • Antibiotics do not appear to be a substantial risk factor for incident pediatric psoriasis.
  • The findings suggest focusing on managing infections rather than solely on antibiotic avoidance for pediatric psoriasis prevention.
Abstract

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