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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.
More importantly, the authors did not segregate patients on the basis of current smoking intensity (number of cigarettes per day) and duration (number of pack-years). This is important, given that there is a known association between smoking and psoriasis.4 Proper analysis of the extent of smoking habits among women in the study who drank more than 5 nonlight beers per week may reveal that smoking status was a confounding variable that distorted the study's results.
Correspondence: Mr Kwatra, Wake Forest University School of Medicine, 100 Medical Center Blvd, Winston-Salem, NC 27157-1071 (skwatra@wfubmc.edu).
Financial Disclosure: None.
Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature
Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal
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The Rational Clinical Examination Cigarette Use
The Rational Clinical Examination The best background information for diagnosing airflow limitation is exposure to cigarette smoke....
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