The effect of smoking on the psoriasis: Is it related to nail involvement?

Psoriasis is a chronic inflammatory skin disease that negatively affects the quality of life with remissions and relapses. Smoking, which is known to accelerate the development of comorbidities that can accompany psoriasis such as atherosclerotic heart disease, metabolic syndrome, is also an independent risk factor for psoriasis. In our study, we aimed to investigate the relationship between smoking and psoriasis. The study included a total of 476 participants with 276 psoriasis patients and 200 healthy volunteers. One hundred and thirty-nine (69.5%) cases in the psoriasis group and 61 (30.5%) cases in the control group were smoking. Patients with psoriasis had more cigarette smoking than the control group (P < .001). Smoking was present in 100 cases (61%) of 164 cases with nail psoriasis and psoriatic nail was significantly more frequently observed in patients with psoriasis when smoking was present (P < .001). It was observed that systemic treatment requirements were higher in smoking psoriasis patients (P = .04). It is known that cigarette use increases in patients with psoriasis compared to the normal population, and cigarette use also increases the psoriasis area severity index (PASI). In our study, a significant relationship was found between smoking and psoriasis nail involvement first in the literature. Furthermore, the need for systemic treatment was higher in smokers.