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Alcohol Intake and Risk of Psoriasis: Smoking as a Confounding Factor

Shawn G. Kwatra, BS
Arch Dermatol. 2011;147(3):358. doi:10.1001/archdermatol.2011.15.
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I read with great interest the study by Qureshi et al1 published in the Archives and also highlighted in the New York Times.2 The study concluded that women who drink more than 5 nonlight beers per week have an increased risk of developing psoriasis. However, this finding may be flawed.

The authors did not provide data on the incidence of smoking in those women who drank more than 5 nonlight beers per week. The percentage of smokers in this group is likely to be very high, given that the percentage of smokers among those who drink more than 2.3 alcoholic beverages of all kinds was 37%, compared with a 22% smoking rate among those who drink between 1.2 and 2.3 alcoholic beverages a week.1 Furthermore, it can be expected that beer drinkers smoke more than wine drinkers because wine drinkers adopt healthier lifestyles, including exercising more and smoking less,3 a finding that could further confound the association between beer drinking and psoriasis.

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March 1, 2011
Abrar A. Qureshi, MD, MPH; Tricia Li, MD, MSc; Jiali Han, PhD
Arch Dermatol. 2011;147(3):358-359. doi:10.1001/archdermatol.2011.16.
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