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已发表论文
物质滥用与银屑病之间的双向关联：一项前瞻性队列研究
Authors Che X, Zhou J, Wang A, Guo J, Zhang C, Xiao Y
Received 2 August 2025
Accepted for publication 28 November 2025
Published 7 January 2026 Volume 2026:16 557781
DOI https://doi.org/10.2147/PTT.S557781
Checked for plagiarism Yes
Review by Single anonymous peer review
Peer reviewer comments 2
Editor who approved publication: Professor Enzo Errichetti
Xuanlin Che,1– 3 Jiatong Zhou,1– 3 Anqi Wang,4 Jia Guo,1– 3 Chengcheng Zhang,5,6 Yi Xiao1– 3
1Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4Department of Dermatology, Third Hospital, Peking University, Beijing, People’s Republic of China; 5Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China; 6Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, People’s Republic of China
Correspondence: Yi Xiao, Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Email xiaoyixy@csu.edu.cn Chengcheng Zhang, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China, Email zhangcc202212@163.com
Background: Psoriasis and substance abuse remains a serious healthcare burden. However, associations between substance abuse and psoriasis have not been elucidated.
Objective: To evaluate the bidirectional associations between substance abuse and psoriasis.
Methods and Subjects: Based on the UK Biobank data, we conducted two prospective cohort studies to compare the risk of incident psoriasis in participants with versus without substance abuse (Cohort 1) and the risk of incident substance abuse in participants with versus without psoriasis (Cohort 2). Incident substance abuse (ICD: F10-F19) and psoriasis (ICD: L40) were primarily determined from hospital and primary care data, death registries and self-assessments.
Results: In Cohort 1, 4,097 of 454,245 developed psoriasis during follow-up. Baseline substance abuse was linked to an increased psoriasis risk (hazard ratio [HR]: 2.31, P< 0.001), notably in alcohol and tobacco users (HRs: 2.29 and 2.33, P< 0.001). Those with high genetic risk and substance abuse had the greatest psoriasis risk (HR: 5.19, P< 0.001). In Cohort 2, 25,176 out of 451,547 were diagnosed with substance abuse during follow-up. A notable association between baseline psoriasis and subsequent substance abuse (HR: 1.28, P< 0.001) was observed, slightly mediated by depression, anxiety, and sleep quality (1.7% to 3.4%; all P< 0.001). Sensitivity analyses showed consistent results.
Conclusion: Our findings identify bidirectional positive associations of substance abuse with psoriasis. This association is especially pronounced in those with both high genetic risk and alcohol or tobacco abuse. It is suggested that clinicians should consider alcohol or tobacco abuse among psoriasis patients to improve their life quality.
Plain Language Summary: What is already known about this topic?
Individual factors, like alcohol or tobacco consumption, have been reported to be associated with psoriasis risk. The bidirectional associations between the incidence of substance abuse and psoriasis remain unclear.
What does this article add to our knowledge?
Our findings emphasize a bidirectional positive relationship between substance abuse incidents and psoriasis. This association is especially pronounced in psoriasis patients with high genetic risk and in those who abuse alcohol and tobacco.
How does this study impact current management guidelines?
Our findings underscore the imperative of proactive measures against both psoriasis and substance abuse, especially concerning alcohol and tobacco.
Keywords: substance abuse, psoriasis, UK Biobank, bidirectional cohorts
1Department of Dermatology, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 2Hunan Engineering Research Center of Skin Health and Disease, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 3National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Central South University, Changsha, People’s Republic of China; 4Department of Dermatology, Third Hospital, Peking University, Beijing, People’s Republic of China; 5Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China; 6Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, People’s Republic of China
Correspondence: Yi Xiao, Department of Dermatology, Xiangya Hospital, Central South University, 87 Xiangya Road, Changsha, Hunan, 410008, People’s Republic of China, Email xiaoyixy@csu.edu.cn Chengcheng Zhang, Department of Epidemiology and Biostatistics, School of Public Health, Guangdong Pharmaceutical University, Guangzhou, People’s Republic of China, Email zhangcc202212@163.com
Background: Psoriasis and substance abuse remains a serious healthcare burden. However, associations between substance abuse and psoriasis have not been elucidated.
Objective: To evaluate the bidirectional associations between substance abuse and psoriasis.
Methods and Subjects: Based on the UK Biobank data, we conducted two prospective cohort studies to compare the risk of incident psoriasis in participants with versus without substance abuse (Cohort 1) and the risk of incident substance abuse in participants with versus without psoriasis (Cohort 2). Incident substance abuse (ICD: F10-F19) and psoriasis (ICD: L40) were primarily determined from hospital and primary care data, death registries and self-assessments.
Results: In Cohort 1, 4,097 of 454,245 developed psoriasis during follow-up. Baseline substance abuse was linked to an increased psoriasis risk (hazard ratio [HR]: 2.31, P< 0.001), notably in alcohol and tobacco users (HRs: 2.29 and 2.33, P< 0.001). Those with high genetic risk and substance abuse had the greatest psoriasis risk (HR: 5.19, P< 0.001). In Cohort 2, 25,176 out of 451,547 were diagnosed with substance abuse during follow-up. A notable association between baseline psoriasis and subsequent substance abuse (HR: 1.28, P< 0.001) was observed, slightly mediated by depression, anxiety, and sleep quality (1.7% to 3.4%; all P< 0.001). Sensitivity analyses showed consistent results.
Conclusion: Our findings identify bidirectional positive associations of substance abuse with psoriasis. This association is especially pronounced in those with both high genetic risk and alcohol or tobacco abuse. It is suggested that clinicians should consider alcohol or tobacco abuse among psoriasis patients to improve their life quality.
Plain Language Summary: What is already known about this topic?
Individual factors, like alcohol or tobacco consumption, have been reported to be associated with psoriasis risk. The bidirectional associations between the incidence of substance abuse and psoriasis remain unclear.
What does this article add to our knowledge?
Our findings emphasize a bidirectional positive relationship between substance abuse incidents and psoriasis. This association is especially pronounced in psoriasis patients with high genetic risk and in those who abuse alcohol and tobacco.
How does this study impact current management guidelines?
Our findings underscore the imperative of proactive measures against both psoriasis and substance abuse, especially concerning alcohol and tobacco.
Keywords: substance abuse, psoriasis, UK Biobank, bidirectional cohorts