Psoriasis — SCE Dermatology MCQ
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Correct answer: A — Alcohol consumption is associated with increased psoriasis severity, reduced treatment response, and increased risk of liver toxicity from systemic therapies (Methotrexate); moderation or cessation is recommended
Alcohol consumption is independently associated with psoriasis severity, treatment resistance, and disease complications. Mechanisms include: pro-inflammatory effects (increased TNF-alpha, IL-6), impaired immune function, worsening of hepatic risk from Methotrexate and other hepatotoxic therapies, and behavioural effects (reduced treatment adherence). BAD guidelines recommend counselling all psoriasis patients about alcohol moderation. Acitretin is specifically contraindicated with alcohol (converts to etretinate — long half-life, teratogenic). Methotrexate requires alcohol restriction (<14 units/week) due to additive hepatotoxicity risk. Alcohol excess also increases Ciclosporin hepatotoxicity risk.
Reference: BAD 2020 Psoriasis Comorbidities; NICE CG153