Hyperglycemia and Alcohol Consumption Linked to Psoriasis Flares in Severe Cases

A retrospective cohort study published in Clinical, Cosmetic and Investigational Dermatology identified hyperglycemia and alcohol consumption as independent risk factors for psoriasis flares in patients with severe disease. The findings underscore the need for clinicians to monitor and manage metabolic factors in patients with psoriasis and coexisting type 2 diabetes mellitus (T2DM) or impaired fasting glucose (IFG). 

The study included 201 patients with psoriasis vulgaris—95 with severe psoriasis and 106 with mild psoriasis—who had at least 2 HbA1c measurements over the study period (2008–2022). Researchers analyzed 1717 follow-up visits using mixed-effects logistic regression to assess associations between hyperglycemia, alcohol consumption, and psoriasis exacerbations. 

Among patients with severe psoriasis, an HbA1c level ≥7% was significantly associated with disease flares (adjusted odds ratio [OR]: 1.905; 95% CI: 1.328–2.731). Alcohol consumption was also an independent predictor of exacerbation (adjusted OR: 3.328; 95% CI: 1.235–8.965). In contrast, no variables, including hyperglycemia, were independently linked to flares in patients with mild psoriasis. 

"Hyperglycemia and alcohol consumption were associated with exacerbation in patients with severe psoriasis who had T2DM/IFG," the authors stated. 

These findings suggest that glycemic control may play a crucial role in psoriasis management, particularly in patients with severe disease. Dermatologists should consider close metabolic monitoring and patient counseling on alcohol use to reduce the risk of flares in this high-risk population.

Reference
Yongpisarn T, Thadanipon K, Suchonwanit P, Rattanakaemakorn P. Hyperglycemia is a potential prognostic factor for exacerbation in severe psoriasis with diabetes or prediabetes. Clin Cosmet Investig Dermatol. Published online February 6, 2025. doi:10.2147/CCID.S502333