Photo Credit: Mysticfalcon
Researchers reviewed risk factors for psoriasis flares, including stress, infections, common drugs, pollution, hormonal changes, COVID-19, vaccines, and more.
Clinicians can improve the QOL of patients diagnosed with psoriasis by maintaining up-to-date patient information and monitoring for risk factors. Moreover, according to a narrative review published in Psoriasis, ensuring routine follow-ups can aid in thwarting and managing flare-ups.
Luca Potestio, LM, and colleagues conducted a narrative review to explore the current literature on risk factors for psoriasis flares and investigate possible mechanisms and their impacts on the disease.
“Clinically, psoriasis vulgaris is the most common phenotype, affecting 85% to 90% of patients,” Dr. Potestio and colleagues wrote. “Several triggering factors may exacerbate or worsen the disease. The knowledge of these risk factors is important to control psoriasis.”
The researchers sourced studies published up to February 2024 using PubMed, Google Scholar, Cochrane Skin, MEDBASE, and Embase databases.
The authors noted that two risk factors for psoriasis exist globally: classic and emerging. Examples of classic risk factors include mechanical stress, infections and dysbiosis of the skin, common drugs, environment and pollution, lifestyle, psychological stress, and hormonal and metabolic alterations.
Several emerging risk factors include cancer therapies such as immune checkpoint inhibitors and small molecule drugs, COVID-19, and vaccines.
“The incidence of cutaneous manifestations secondary to the SARS-CoV-2 infection is between 4% and 20.4%,” the authors wrote.
They added, “Vaccination is an uncommon trigger for psoriasis flares. Before the COVID-19 pandemic, cases of psoriasis flare-ups were reported following vaccination for influenza, pneumococcal pneumonia, tetanus and diphtheria, and yellow fever…Several cutaneous AEs have been described in patients receiving COVID-19 vaccination; in particular, cases of psoriasis occurring de novo or psoriasis flare-ups have been reported.”
The researchers also noted that clinicians face challenges preventing the onset of psoriasis and its flares. They wrote that eradicating factors that may trigger the disease and exacerbations is critical for controlling psoriasis.
“Several factors interact with each other and may directly and/or indirectly affect psoriasis course. Certainly, further studies will allow us to establish possible preventive options in order to provide patients [with] personalized treatment strategies and personalized care plans,” they wrote.
Dr. Potestio and colleagues concluded that accurate and up-to-date patient information, meticulous monitoring for risk factors, and routine healthcare visits have the potential to avert and effectively manage psoriasis and related exacerbations, ultimately enhancing patients’ HRQOL.
