Journal Menu

Annals of Medicine and Medical Education
Volume 2, Issue 3 (November 2015), pp. 57-64

DOI: 10.12973/ejms.2015.144p

Downloaded 1025 times.

Research Article

Published online on Nov 01, 2015

How to reference this article?

 

Assessing Effect of Infection in Each Season of the Year on Recurrence of Psoriasis: Using the Time-Dependent Coefficient Rates Model for Recurrent Event Data

Freshteh Osmani, Ebrahim Hajizadeh & Parvin Monsouri

Abstract

Psoriasis can be provoked or exacerbated by a variety of different environmental factors, particularly infections. This disease may occur frequently for a person. Therefore, it's placed in recurrent event category. Unfortunately, few studies have determined which factors are independently associated with psoriasis. We attempted to provide an estimate of the risk for psoriasis associated with a recent infectious disease in different seasons of year and to explore other potential risk factors. The current study was conducted at the Department of Dermatology, Imam Khomeini Hospital, Tehran University of Medical Sciences, between March 2006 and April 2014. A total of 160 patients with confirmed diagnosis of psoriasis were included in the analysis. The original outcomes of the study were recurrent event times. Time dependent rate model was applied to assess the estimate of the effect of infection in different seasons association with psoriasis recurrence and also investigate other affective factors. Up to 6 recurrences were observed during the study time, but only 10% of the patients experienced more than 3 recurrences. The results showed positive correlation between the impact of infection in cold weather and recurrence of psoriasis (P < 0.001).The risk increased with the reported history of any infectious disease. According to the results of model fitting, the impact of infection on recurrence of psoriasis was significantly different in different seasons, so that patients who had infections faced with a higher recurrence risk during the winter (P < 0.01). The patients with types of infections were more likely to experience psoriasis recurrence especially in the winter. Therefore it can be concluded that changes of season of year infections even streptococcal infection in cool weather may provide the progression of the psoriasis and the hazard of its recurrence. 

Keywords: psoriasis, recurrent event, infection, time-dependent coefficient rates model


References
  1. Raychaudhuri SP, Farber EM. The prevalence of psoriasis in the world. Journal of the European Academy of Dermatology and Venereology : JEADV. 2001 Jan;15(1):16-7. PubMed PMID: 11451313.
  2. Giardina E SC, Novelli G. The psoriasis genetics as a model of complex disease. Curr Drug Targets Inflamm Alergy. 2004;3:129–36.
  3. Kormeili T, Lowe NJ, Yamauchi PS. Psoriasis: immunopathogenesis and evolving immunomodulators and systemic therapies; U.S. experiences. The British journal of dermatology. 2004 Jul;151(1):3-15. PubMed PMID: 15270867.
  4. Guilhou JJ MJ. New hypotheses in the genetics of psoriasis and other “complex” diseases. Dermatology. 2008 (216):87–92.
  5. 5.  Yazici AC KA, Ozen O, EkSio2lu M, Ustün H. Expression of p53 in lesions and unaffected skin of patients with plaque-type and guttate psoriasisa quantitative comparative study. J Dermatol. 2007 (34):367–74.
  6. Higgins EM PT, du Vivier AW. Smoking, drinkingand psoriasis. The British journal of dermatology. 1993 (28):730–2.
  7. Naldi L CL, Linder D et al. Ciggarete smoking, body mass index, and stressful life events as risk factors for psoriasis: result from an Italian case-control study. J Invest Dermatol. 2005 (127):61–7.
  8. Naldi L PF, Brevi A et al. Family history, smoking habits, alcohol consumption and risk of psoriasis. Br J Dermatology. 1992 (127):212–7.
  9. Naldi L PL, Parazzini F, Carrel CF. Psoriasis Study Group of the Italian group for Epidemiological Research in Dermatology. Family history of psoriasis, stressful life events and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: result of a case-control study. J Am Acad Dermatol. 2001 (44):433–8.
  10. Zhao G FX, Na A et al. Acute guttate psoriasis patients have positive streptococcus hemolyticus throat cultures and elevated antistreptococcal M6 protein titers. J Dermatol. 2005 (32):91–6.
  11. Liu Y KJ, Bowcock AM. Psoriasis: genetic associations and immune system changes.Genes and immunity. PubMed PMID: 17093502. 2007;8(1):1-12.
  12. Esmaily N EA, Noormohammadpour P, Baiagouy I, Sayanjali, S. Psoriasis Recurrence Rate and its Relationship with Initial Corticosteroid Dose. Iran J Dermatol. 2010;13(4):118–21.
  13. Lewis HM BB, Bokth S, Powles AV, Garioch JJ,, Valdimarsson H ea. Restricted T-cell receptor V-beta gene usage in the skin of patients with guttate and chronic plaque psoriasis. The British journal of dermatology. 1993 (129):514-20.
  14. Bolton GG DC. A family outbreak of acute guttate psoriasis. Arch Dermatol. 1990 (126):1523-4.
  15. Gupta MA GA, Kirkby S, Schork NJ,Gorr SK, Ellis CN, et al. A psychocutaneous profile of psoriasis patients who are stress reactors: a study of 127 patients. Gen Hosp Psychiatry. 1989 (11):166-73.
  16. Amorim LD CJ, Zeng D, Barreto ML. Regression splines in the time-dependent coefficient rates model for recurrent event data. Stat Med. 2008 (7):5890-906.
  17. Seishima M SM, Mori S, Noma A. Serum lipid and apolipoprotein levels in patients with psoriasis. The British journal of dermatology. 1994 (130):738-7.
  18. Azizzadeh M GR, Sharafi M. Serum lipids profiles in psoriatic patients. Koomesh. 2010 (12):307-12.