Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on sleep in brain health

LIVE: Thursday 2nd May 2024, 18:00-19:30 (CEST)

Quality sleep is essential for health. But what happens to our brains when sleep patterns are disturbed? Join our experts to explore the interplay between sleep disruption and neurological diseases, and the questions that you need to be asking your patients to help you prevent the harmful effects of sleep deprivation.
ADVANCED SEARCH
Log in
Top
BMC Medicine
Published in: BMC Medicine 1/2017

Open Access 01-12-2017 | Research article

Risk and predictors of psoriasis in patients with breast cancer: a Swedish population-based cohort study

Authors: Haomin Yang, Judith S. Brand, Jingmei Li, Jonas F. Ludvigsson, Emilio Ugalde-Morales, Flaminia Chiesa, Per Hall, Kamila Czene

Published in: BMC Medicine | Issue 1/2017

Login to get access

Abstract

Background

The risk of psoriasis in patients with breast cancer is largely unknown, as available evidence is limited to case findings. We systematically examined the incidence and risk factors of psoriasis in patients with breast cancer.

Methods

A Swedish nationwide cohort of 56,235 breast cancer patients (2001–2012) was compared to 280,854 matched reference individuals from the general population to estimate the incidence and hazard ratio (HR) of new-onset psoriasis. We also calculated HRs for psoriasis according to treatment, genetic, and lifestyle factors in a regional cohort of 8987 patients.

Results

In the nationwide cohort, 599 patients with breast cancer were diagnosed with psoriasis during a median follow-up of 5.1 years compared to 2795 cases in the matched reference individuals. This corresponded to an incidence rate of 1.9/1000 person-years in breast cancer patients vs. 1.7/1000 person-years in matched reference individuals. Breast cancer patients were at an increased risk of psoriasis (HR = 1.17; 95% confidence interval (CI) = 1.07–1.28), especially its most common subtype (psoriasis vulgaris; HR = 1.33; 95% CI = 1.17–1.52). The risk of psoriasis vulgaris was highest shortly after diagnosis but remained increased up to 12 years. Treatment-specific analyses indicated a higher risk of psoriasis in patients treated with radiotherapy (HR = 2.44; 95% CI = 1.44–4.12) and mastectomy (HR = 1.54, 95% CI = 1.03–2.31). Apart from treatment-specific effects, we identified genetic predisposition, obesity, and smoking as independent risk factors for psoriasis in breast cancer patients.

Conclusions

The incidence of psoriasis is slightly elevated among patients with breast cancer, with treatment, lifestyle, and genetic factors defining the individual risk profile.
Appendix
Available only for authorised users
Literature
1.
Lindberg M, Isacson D, Bingefors K. Self-reported skin diseases, quality of life and medication use: a nationwide pharmaco-epidemiological survey in Sweden. Acta Derm Venereol. 2014;94(2):188–91.CrossRefPubMed
2.
Danielsen K, Olsen AO, Wilsgaard T, Furberg AS. Is the prevalence of psoriasis increasing? A 30-year follow-up of a population-based cohort. Br J Dermatol. 2013;168(6):1303–10.CrossRefPubMed
3.
Hrehorow E, Salomon J, Matusiak L, Reich A, Szepietowski JC. Patients with psoriasis feel stigmatized. Acta Derm Venereol. 2012;92(1):67–72.CrossRefPubMed
4.
Schmid-Ott G, Schallmayer S, Calliess IT. Quality of life in patients with psoriasis and psoriasis arthritis with a special focus on stigmatization experience. Clin Dermatol. 2007;25(6):547–54.CrossRefPubMed
5.
Obradors M, Blanch C, Comellas M, Figueras M, Lizan L. Health-related quality of life in patients with psoriasis: a systematic review of the European literature. Qual Life Res. 2016;25(11):2739–54.CrossRefPubMed
6.
Alolabi N, White CP, Cin AD. The Koebner phenomenon and breast reconstruction: Psoriasis eruption along the surgical incision. Can J Plast Surg. 2011;19(4):143–4.CrossRefPubMedPubMedCentral
7.
Pastore F, Conson M, D'Avino V, Palma G, Liuzzi R, Solla R, Farella A, Salvatore M, Cella L, Pacelli R. Dose-surface analysis for prediction of severe acute radio-induced skin toxicity in breast cancer patients. Acta Oncol. 2016;55(4):466–73.CrossRefPubMed
8.
Schreiber GJ, Muller-Runkel R. Exacerbation of psoriasis after megavoltage irradiation. The Koebner phenomenon. Cancer. 1991;67(3):588–9.CrossRefPubMed
9.
Charalambous H, Bloomfield D. Psoriasis and radiotherapy: exacerbation of psoriasis following radiotherapy for carcinoma of the breast (the Koebner phenomenon). Clin Oncol. 2000;12(3):192–3.
10.
Tomlinson MJ. Psoriasis and radiotherapy. Clin Oncol. 2001;13(2):145.
11.
Cook C, Wongkittiroch K, Miller R. Erythrodermic psoriasis post radiation treatment: a case presentation and literature review. Practical Dermatology. 2011;10:36–8.
12.
Farber EM, Nall ML. The natural history of psoriasis in 5,600 patients. Dermatologica. 1974;148(1):1–18.CrossRefPubMed
13.
Lonnberg AS, Skov L, Skytthe A, Kyvik KO, Pedersen OB, Thomsen SF. Heritability of psoriasis in a large twin sample. Br J Dermatol. 2013;169(2):412–6.CrossRefPubMed
14.
Armstrong AW, Harskamp CT, Dhillon JS, Armstrong EJ. Psoriasis and smoking: a systematic review and meta-analysis. Br J Dermatol. 2014;170(2):304–14.CrossRefPubMed
15.
Brenaut E, Horreau C, Pouplard C, Barnetche T, Paul C, Richard MA, Joly P, Le Maitre M, Aractingi S, Aubin F, et al. Alcohol consumption and psoriasis: a systematic literature review. J Eur Acad Dermatol Venereol. 2013;27 Suppl 3:30–5.CrossRefPubMed
16.
Armstrong AW, Harskamp CT, Armstrong EJ. The association between psoriasis and obesity: a systematic review and meta-analysis of observational studies. Nutr Diabetes. 2012;2:e54.CrossRefPubMedPubMedCentral
17.
Yin X, Cheng H, Lin Y, Wineinger NE, Zhou F, Sheng Y, Yang C, Li P, Li F, Shen C, et al. A weighted polygenic risk score using 14 known susceptibility variants to estimate risk and age onset of psoriasis in Han Chinese. PLoS One. 2015;10(5):e0125369.CrossRefPubMedPubMedCentral
18.
Ludvigsson JF, Andersson E, Ekbom A, Feychting M, Kim JL, Reuterwall C, Heurgren M, Olausson PO. External review and validation of the Swedish National Inpatient Register. BMC Public Health. 2011;11:450.CrossRefPubMedPubMedCentral
19.
Lofvendahl S, Theander E, Svensson A, Carlsson KS, Englund M, Petersson IF. Validity of diagnostic codes and prevalence of physician-diagnosed psoriasis and psoriatic arthritis in southern Sweden—a population-based register study. PLoS One. 2014;9(5):e98024.CrossRefPubMedPubMedCentral
20.
Michailidou K, Hall P, Gonzalez-Neira A, Ghoussaini M, Dennis J, Milne RL, Schmidt MK, Chang-Claude J, Bojesen SE, Bolla MK, et al. Large-scale genotyping identifies 41 new loci associated with breast cancer risk. Nat Genet. 2013;45(4):353–61. 361e351-352.CrossRefPubMedPubMedCentral
21.
Tsoi LC, Spain SL, Knight J, Ellinghaus E, Stuart PE, Capon F, Ding J, Li Y, Tejasvi T, Gudjonsson JE, et al. Identification of 15 new psoriasis susceptibility loci highlights the role of innate immunity. Nat Genet. 2012;44(12):1341–8.CrossRefPubMedPubMedCentral
22.
Chang CC, Chow CC, Tellier LC, Vattikuti S, Purcell SM, Lee JJ. Second-generation PLINK: rising to the challenge of larger and richer datasets. GigaScience. 2015;4(1):7.CrossRefPubMedPubMedCentral
23.
Michailidou K, Beesley J, Lindstrom S, Canisius S, Dennis J, Lush MJ, Maranian MJ, Bolla MK, Wang Q, Shah M, et al. Genome-wide association analysis of more than 120,000 individuals identifies 15 new susceptibility loci for breast cancer. Nat Genet. 2015;47(4):373–80.CrossRefPubMedPubMedCentral
24.
Holt J, Prentice R. Survival analyses in twin studies and matched pair experiments. Biometrika. 1974;61(1):17–30.CrossRef
25.
Sjolander A, Greenland S. Ignoring the matching variables in cohort studies — when is it valid and why? Stat Med. 2013;32(27):4696–708.CrossRefPubMed
26.
Cummings P, McKnight B. Analysis of matched cohort data. Stata J. 2004;4:274–81.
27.
Brand JS, Colzani E, Johansson AL, Giesecke J, Clements M, Bergh J, Hall P, Czene K. Infection-related hospitalizations in breast cancer patients: risk and impact on prognosis. J Infect. 2016;72(6):650–8.CrossRefPubMed
28.
Yoshikawa N, Inomata T, Shimbo T, Takahashi M, Uesugi Y, Juri H, Narumi Y. Appropriate evaluation of and risk factors for radiation dermatitis in breast cancer patients receiving hypofractionated whole-breast irradiation after breast-conserving surgery. Breast Cancer. 2014;21(2):170–6.CrossRefPubMed
29.
Vinton AL, Traverso LW, Jolly PC. Wound complications after modified radical mastectomy compared with tylectomy with axillary lymph node dissection. Am J Surg. 1991;161(5):584–8.CrossRefPubMed
30.
31.
Naldi L, Peli L, 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: results of a case-control study. J Am Acad Dermatol. 2001;44(3):433–8.CrossRefPubMed
32.
Tsoi LC, Stuart PE, Tian C, Gudjonsson JE, Das S, Zawistowski M, Ellinghaus E, Barker JN, Chandran V, Dand N, et al. Large scale meta-analysis characterizes genetic architecture for common psoriasis associated variants. Nat Commun. 2017;8:15382.CrossRefPubMedPubMedCentral
33.
Chen H, Poon A, Yeung C, Helms C, Pons J, Bowcock AM, Kwok PY, Liao W. A genetic risk score combining ten psoriasis risk loci improves disease prediction. PLoS One. 2011;6(4):e19454.CrossRefPubMedPubMedCentral
34.
Naldi L, Chatenoud L, Linder D, Fortina AB, Peserico A, Virgili AR, Bruni PL, Ingordo V, Lo Scocco G, Solaroli C, et al. Cigarette smoking, body mass index, and stressful life events as risk factors for psoriasis: results from an Italian case-control study. J Invest Dermatol. 2005;125(1):61–7.CrossRefPubMed
35.
Singh M, Alavi A, Wong R, Akita S. Radiodermatitis: a review of our current understanding. Am J Clin Dermatol. 2016;17(3):277–92.CrossRefPubMed
Metadata
Title
Risk and predictors of psoriasis in patients with breast cancer: a Swedish population-based cohort study
Authors
Haomin Yang
Judith S. Brand
Jingmei Li
Jonas F. Ludvigsson
Emilio Ugalde-Morales
Flaminia Chiesa
Per Hall
Kamila Czene
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Medicine / Issue 1/2017
Electronic ISSN: 1741-7015
DOI
https://doi.org/10.1186/s12916-017-0915-4

Other articles of this Issue 1/2017

BMC Medicine 1/2017 Go to the issue

Research article

The clinical utility of the urine-based lateral flow lipoarabinomannan assay in HIV-infected adults in Myanmar: an observational study

Research article

Comprehensive metabolic profiling of chronic low-grade inflammation among generally healthy individuals

Review

Post-stroke dementia – a comprehensive review

Research article

Use of whole-genome sequencing to distinguish relapse from reinfection in a completed tuberculosis clinical trial

Minireview

Non-alcoholic fatty liver disease

Research article

Abnormal epigenetic changes during differentiation of human skeletal muscle stem cells from obese subjects