Atopic dermatitis and a family history of psoriasis, as well as viral and bacterial skin infections and fungal infections in early life, were associated with pediatric psoriasis development, according to a study published in the Journal of the American Academy of Dermatology. Researchers conducted a nationwide nested case-control study from 2000-2017, identifying 1,527 patients with pediatric psoriasis from the National Health Insurance Research Database of Taiwan. The study team matched patients with psoriasis with 15,270 individuals without the condition. On multivariate analysis, factors independently associated with pediatric psoriasis were atopic dermatitis (adjusted OR [aOR], 2.07) and family history of psoriasis, especially of the mother (aOR, 9.86) or another first-degree relative (aOR, 5.49). Significant associations with pediatric psoriasis were seen for skin viral and bacterial infections (aOR, 1.35) and fungal infections (aOR, 1.71) in the first 2 years of life. No correlation was seen for systemic antibiotic exposure, and the results were consistent at different time periods across sensitivity analyses. “The role of early-life microbiota dysbiosis in the pathogenesis of pediatric psoriasis might be worth further investigation,” the authors wrote.

Papers on COVID-19 in Psoriasis, Psoriatic Arthritis Carry Risk for Bias

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Papers addressing the risk for, and related outcomes with, COVID-19 in patients with psoriasis and psoriatic arthritis prescribed biologic therapies have a high risk for bias, according to a study published in the Journal of Investigative Dermatology. Investigators analyzed the quality of papers addressing the risk for, and related outcomes with, COVID-19 in patients with psoriasis and psoriatic arthritis on biologic therapies. The quality of 25 published studies was estimated using the Newcastle-Ottawa Scale (NOS). The median NOS scores were 47% and 44% for psoriasis and psoriatic arthritis, respectively, indicating a high risk for bias. Of the psoriasis and psoriatic arthritis studies, 37% and 44%, respectively, included patients with suspected COVID-19 without a positive swab. None of the studies provided a calculation of formal sample size. “Our study is not intended as a criticism to the authors or the journals that published their research,” the study authors said in a statement. “Rather, it is a reminder to be careful when reading new COVID-19 papers. During a pandemic, health care providers should be more cautious when incorporating evidence from new studies into personal decision making.”