• Mark J Schwade, Lillie Tien, Jennifer L Waller, Loretta S Davis, Stephanie L Baer, Azeem Mohammed, Lufei Young, Mufaddal F Kheda, and Wendy B Bollag.
• Department of Medicine, Medical College of Georgia at Augusta University, Augusta, Georgia.
• Am. J. Med. Sci. 2021 Jul 1; 362 (1): 24-33.

BackgroundPsoriasis impairs the quality of life of approximately 7.5 million Americans and is associated with serious comorbidities. Because of chronic vascular access and epidermal dysfunction, end-stage renal disease (ESRD) patients with psoriasis may be at greater risk for infection, and psoriasis treatment could affect this risk.MethodsA retrospective cohort analysis was performed using the United States Renal Data System from 2004-2011 to investigate the association of psoriasis with infections common to ESRD patients, as well as the effect of psoriasis treatment on infection risk as well as mortality.ResultsA total of 8,911 psoriasis patients were identified. Psoriasis was associated with a significantly increased risk for all queried infections, especially cellulitis (adjusted relative risk = 1.55), conjunctivitis (1.47), and onychomycosis (1.36). Psoriasis treatment (systemic, local, and light) was associated with a significantly decreased risk of some infections. Psoriasis treatment was also correlated with a significantly decreased risk of mortality, with systemic therapies (biologics and other immunosuppressants) showing the greatest reduction (adjusted hazard ratio = 0.55).ConclusionsThese results suggest that psoriasis-ESRD patients may have an increased risk of infection and treatment of psoriasis is associated with a reduced risk of some infections and improved survival.Published by Elsevier Inc.

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