High prevalence of alcohol use disorders in patients with inflammatory skin diseases

BackgroundThere is a known association between psoriasis and heavy alcohol consumption. The association between heavy alcohol consumption and other inflammatory skin diseases remains to be defined. ObjectivesTo examine the prevalence of heavy drinking using the Alcohol Use Disorders Identification Test (AUDIT) in patients with inflammatory skin disease. MethodsWe conducted an observational cross-sectional study in a single hospital outpatient department. We recruited 609 patients with either psoriasis, eczema, cutaneous lupus or other inflammatory disorders, and a reference population with skin lesions. Primary outcome was the proportion of patients in each group with an alcohol use disorder (AUD). ResultsThe observed prevalence of AUD was 306% in patients with psoriasis, 333% in those with eczema, 123% in those with cutaneous lupus, 218% in those with other inflammatory disease and 143% in those with non-inflammatory disease. Odds ratios (OR) for AUD in patients in the inflammatory groups compared with those in the noninflammatory groups, adjusted for age and sex, were as follows: psoriasis 165 [95% confidence interval (CI) 086-317], eczema 200 (95% CI 103-385), lupus 103 (95% CI 039-271), other inflammatory disease 132 (95% CI 068-256). ORs were reduced if also adjusted for Dermatology Life Quality Index (DLQI). The prevalence of DLQI 11 was 311% for psoriasis, 437% for eczema, 175% for cutaneous lupus, 172% for other inflammatory disease and 28% for noninflammatory disease. ConclusionsPatients with eczema attending a hospital clinic have been shown to have high levels of AUD of a similar level to patients with psoriasis and higher than patients with noninflammatory skin diseases.