Shen Fanlingzi, Ding Yuning, Qiang Yan, Duan Zhen, Xu Quanruo, Gao Xiangjin, Zhang Rui, Wang Ruiping
Clinical Research Center, Shanghai Skin Disease Hospital, School of Medicine, Tongji University, Shanghai, People's Republic of China.
School of Public Health, Shanghai University of Traditional Chinese Medicine, Shanghai, People's Republic of China.
Psoriasis (Auckl). 2025 Jul 14;15:261-272. doi: 10.2147/PTT.S534032. eCollection 2025.
Tobacco smoking is an unhealthy behavior associated with the onset, severity, and treatment response of psoriasis. However, evidence regarding the impact of tobacco smoking on the relapse of psoriasis remains limited. This study aims to examine the relapse condition in psoriasis patients and explore the association between tobacco smoking and psoriasis relapse.
We conducted an observational study with 551 psoriasis patients recruited from 2022 to 2024 in Shanghai Skin Disease Hospital. A structured questionnaire and physical examination were used to collect data at baseline, week 12, week 24 and week 48. PASI50 and PASI75 were used to evaluate the improvement of psoriasis patients after treatment at week 12, and disease relapse was defined as the loss of 50% PASI improvement during clinical remission after the achievement of PASI50 or PASI75 at week 12.
75.7% of the 551 psoriasis patients were males, with an average age of 45.8 years, and 282 (51.2%) were tobacco smokers. 41.2% and 61.6% of psoriasis patients with PASI50 achievement at week 12 encounter disease relapsed at week 24 and 48, respectively, while for patients with PASI75 achievement at week 12, the relapse rate was 27.6% and 51.7% at week 24 and 48, respectively. Logistic regression indicated that patients with tobacco smoking had a higher relapse rate, especially among those with PASI75 achievement at week 12. The odds ratio was 2.10 (95% CI: 1.17-3.78) and 1.84 (95% CI: 1.07-3.14) at week 24 and week 48 respectively, even after adjusting for potential confounding factors. Moreover, patients with longer smoking duration and more daily cigarette consumption had higher relapse rate.
Tobacco smoking was positively correlated with the relapse, especially among those with longer smoking duration and more daily cigarette consumption. Therefore, patients with psoriasis should quit smoking to reduce the risk of relapse.
吸烟是一种与银屑病的发病、严重程度及治疗反应相关的不健康行为。然而，关于吸烟对银屑病复发影响的证据仍然有限。本研究旨在调查银屑病患者的复发情况，并探讨吸烟与银屑病复发之间的关联。
我们进行了一项观察性研究，纳入了2022年至2024年在上海皮肤病医院招募的551例银屑病患者。在基线、第12周、第24周和第48周使用结构化问卷和体格检查收集数据。使用PASI50和PASI75评估银屑病患者在第12周治疗后的改善情况，疾病复发定义为在第12周达到PASI50或PASI75后临床缓解期间PASI改善丧失50%。
551例银屑病患者中75.7%为男性，平均年龄45.8岁，282例（51.2%）为吸烟者。在第12周达到PASI50的银屑病患者中，分别有41.2%和61.6%在第24周和第48周复发，而在第12周达到PASI75的患者中，第24周和第48周的复发率分别为27.6%和51.7%。逻辑回归表明，吸烟者的复发率较高，尤其是在第12周达到PASI75的患者中。即使在调整潜在混杂因素后，第24周和第48周的比值比分别为2.10（95%CI：1.17 - 3.78）和1.84（95%CI：1.07 - 3.14）。此外，吸烟时间越长、每日吸烟量越多的患者复发率越高。
吸烟与复发呈正相关，尤其是在吸烟时间长和每日吸烟量多的患者中。因此，银屑病患者应戒烟以降低复发风险。
