Association between palmoplantar pustulosis and cigarette smoking in Brazil: a case-control study

J Eur Acad Dermatol Venereol. 2009 Oct;23(10):1173-7. doi: 10.1111/j.1468-3083.2009.03282.x. Epub 2009 Apr 23.


Background: Palmoplantar pustulosis (PPP) discloses some differences compared to vulgar psoriasis (PV) in terms of age of onset, female predominance and low occurrence of psoriasis lesions elsewhere. Cigarette smoking has been associated to PPP in international studies; nevertheless, these studies were never performed among Brazilian.

Objectives: To compare prevalence of smoking among PPP, PV and other dermatologic patients (NPD).

Methods: Case-control study involving 25 PPP patients from a reference psoriasis centre. Two control groups were matched according to gender and age: 50 patients with PV and 50 NPD. Confounders were adjusted by conditional multiple logistic regression.

Results: Among cases, 84.0% were female and PPP age of disease onset (41.4 years) was greater than PV (34.5 years). Prevalence of ever smoking was higher among cases (92.0%) than PV (52.0%) and NPD (30.0%). Adjusted odds ratio of PPP ever smoking compared to PV and NPD was 9.5 and 36.2, respectively. All smokers reported the onset of their habit before the development of PPP.

Conclusions: There was significant association between PPP and smoking. However, the impact of giving it up in the clinical course of the disease remains to be established.

MeSH terms

  • Adult
  • Brazil
  • Case-Control Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Psoriasis / complications*
  • Smoking*
  • Tobacco*