A review of antibiotics and psoriasis: induction, exacerbation, and amelioration

Area of Science:

• Dermatology
• Pharmacology
• Immunology

Background:

• Psoriasis is influenced by environmental factors like infections and antibiotics.
• The precise relationship between antibiotic use and psoriasis is not well-understood.
• Some antibiotics may trigger psoriasis, while others could aid in its control.

Purpose of the Study:

• To review existing evidence on antibiotics and psoriasis.
• To identify potentially appropriate antibiotic choices for psoriasis patients.
• To synthesize current knowledge on antibiotic mechanisms in psoriasis.

Main Methods:

• Comprehensive literature search of PubMed, Embase, Clinicalkey, and Google Scholar up to May 2019.
• Inclusion of randomized controlled trials, controlled studies, and cohort studies.
• Analysis of data concerning 13 different types of antibiotics and their effects on psoriasis.

Main Results:

• Macrolides and rifampin demonstrated a reduction in Psoriasis Area and Severity Index (PASI) scores in plaque-type psoriasis.
• Penicillin did not show statistically significant improvement for guttate psoriasis.
• Tetracyclines, previously considered triggers, lacked robust evidence from case or retrospective studies.

Conclusions:

• Antibiotic mechanisms in psoriasis may involve immunomodulation rather than solely antibacterial effects.
• Further research is needed on genetic susceptibility, microbiota impact, and precise modes of action.
• Evidence suggests differential effects of antibiotics based on psoriasis subtype and specific drug class.