TY - JOUR
T1 - Infantile infection and antibiotic exposure in association with pediatric psoriasis development
T2 - A nationwide nested case-control study
AU - Chen, Yi Ju
AU - Ho, Hsiu J.
AU - Wu, Chen Yi
AU - Juan, Chao Kuei
AU - Wu, Chun Ying
N1 - Publisher Copyright:
© 2020 American Academy of Dermatology, Inc.
PY - 2021/9
Y1 - 2021/9
N2 - Background: Microbiol dysbiosis and antibiotic exposure have been implicated in the pathogenesis of pediatric inflammatory diseases. Objectives: To investigate the impacts of infantile infection and antibiotic exposure on pediatric psoriasis development. Methods: This is a nationwide nested case-control study. From the National Health Insurance Research Database of Taiwan, a total of 1527 patients with pediatric psoriasis were identified and matched with 15,270 reference individuals without psoriasis, for the period of 2000 to 2017. Demographic characteristics and comorbidities were compared. Conditional stepwise logistic regression analysis was conducted to examine the associations. Results: The mean ages were 9.9 ± 3.7 years in both groups. Atopic dermatitis (adjusted odds ratio [aOR], 2.07; 95% confidence interval [CI], 1.84-2.32) and family history of psoriasis, especially of the mother (aOR, 9.86; 95% CI, 6.89-14.10) or other first-degree relatives (aOR, 5.49; 95% CI, 3.91-7.70), were independently associated with pediatric psoriasis on multivariate analyses. Skin viral and bacterial infections (aOR, 1.35; 95% CI, 1.13-1.62) and fungal infections (aOR, 1.71; 95% CI, 1.44-2.04) in the first 2 years of life were significantly associated with pediatric psoriasis. Systemic antibiotic exposure was not. These results were consistent at different time periods across sensitivity analyses. Limitation: Information about diet and lifestyle was not available. Conclusion: Skin infections at an early age were associated with pediatric psoriasis development.
AB - Background: Microbiol dysbiosis and antibiotic exposure have been implicated in the pathogenesis of pediatric inflammatory diseases. Objectives: To investigate the impacts of infantile infection and antibiotic exposure on pediatric psoriasis development. Methods: This is a nationwide nested case-control study. From the National Health Insurance Research Database of Taiwan, a total of 1527 patients with pediatric psoriasis were identified and matched with 15,270 reference individuals without psoriasis, for the period of 2000 to 2017. Demographic characteristics and comorbidities were compared. Conditional stepwise logistic regression analysis was conducted to examine the associations. Results: The mean ages were 9.9 ± 3.7 years in both groups. Atopic dermatitis (adjusted odds ratio [aOR], 2.07; 95% confidence interval [CI], 1.84-2.32) and family history of psoriasis, especially of the mother (aOR, 9.86; 95% CI, 6.89-14.10) or other first-degree relatives (aOR, 5.49; 95% CI, 3.91-7.70), were independently associated with pediatric psoriasis on multivariate analyses. Skin viral and bacterial infections (aOR, 1.35; 95% CI, 1.13-1.62) and fungal infections (aOR, 1.71; 95% CI, 1.44-2.04) in the first 2 years of life were significantly associated with pediatric psoriasis. Systemic antibiotic exposure was not. These results were consistent at different time periods across sensitivity analyses. Limitation: Information about diet and lifestyle was not available. Conclusion: Skin infections at an early age were associated with pediatric psoriasis development.
KW - antibiotics
KW - infantile
KW - infection
KW - microbiota
KW - nested case-control study
KW - pediatric psoriasis
UR - http://www.scopus.com/inward/record.url?scp=85099314008&partnerID=8YFLogxK
U2 - 10.1016/j.jaad.2020.12.014
DO - 10.1016/j.jaad.2020.12.014
M3 - Article
C2 - 33321158
AN - SCOPUS:85099314008
SN - 0190-9622
VL - 85
SP - 626
EP - 635
JO - Journal of the American Academy of Dermatology
JF - Journal of the American Academy of Dermatology
IS - 3
ER -