Infantile skin infection ups risk of paediatric psoriasis

Skin infections at an early age, but not antibiotic exposure, significantly contributes to the development of paediatric psoriasis, a recent study has shown.

“Microbiol dysbiosis and antibiotic exposure have been implicated in the pathogenesis of paediatric inflammatory diseases,” according to the investigators, who then examined the impacts of infantile infection and antibiotic exposure on paediatric psoriasis developement.

A nationwide nested case-control study was conducted in 1,527 patients with paediatric psoriasis, who were identified from the National Health Insurance Research Database of Taiwan and matched with 15,270 reference individuals without psoriasis, for the period of 2000 to 2017.

The investigators compared demographic characteristics and comorbidities and carried out a conditional stepwise logistic regression analysis to examine the associations. Both patients and controls had a mean age of 9.9±3.7 years.

Multivariate analyses revealed that atopic dermatitis (adjusted odds ratio [AOR], 2.07, 95 percent confidence interval [CI], 1.84–2.32) and family history of psoriasis, especially of the mother (AOR, 9.86, 95 percent CI, 6.89–14.10) or other first-degree relatives (AOR, 5.49, 95 percent CI, 3.91–7.70) independently correlated with paediatric psoriasis.

In addition, skin viral and bacterial infections (AOR, 1.35, 95 percent CI, 1.13–1.62) and fungal infections (AOR, 1.71, 95 percent CI, 1.44–2.04) in the first 2 years of life significantly contributed to the development of paediatric psoriasis. Systemic antibiotic exposure, on the other hand, was not associated with such risk.

“These results were consistent at different time periods across sensitivity analyses,” the investigators said, noting that the study was limited by the lack of information on diet and lifestyle.