Association between Palmoplantar Pustulosis and Cigarette Smoking in Korean

Son, Hyun Ho; Lee, Young Seok; Lee, Sook Kyung

Abstract

BACKGROUND
Palmoplantar pustulosis (PPP), a skin disease, is characterized by chronically recurring sterile pustules on the palms and the soles. Although the etiology of PPP is unknown, it is interesting to note high prevalence of tobacco use in these patients. It would seem that there may be a relationship between PPP, autoimmune disease and alterations of thyroid function. However, this fact was never verified among Korean.
OBJECTIVE
This study aims to explore smoking as a risk or exacerbation factor for PPP in Korean patients with PPP, and confirm the relationship between PPP and other factors, including thyroid disease.
METHODS
We studied a total of 109 patients (M:F=38:71) with ages ranging from 20 to 70 years, diagnosed with PPP. A control group was matched according to gender and age: 109 patients with other dermatologic problem. Patients were interviewed about tobacco use, and thyroid disease, and autoimmune diseases. The data were analyzed to determine whether there was any association between PPP and various factors.
RESULTS
The proportion of PPP patients using tobacco was much higher than that of the control group (p<0.05). Smoking was more strongly associated with PPP among women. Although there was no association between the quantity of cigarettes smoked daily and the severity of PPP, there was a dose-dependent correlation between the pack*year and the severity of PPP (p<0.05). Furthermore, 14 patients had been diagnosed with thyroid disease. In addition, all of them were smokers.
CONCLUSION
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. In addition, it would seem that there may be a relationship between PPP and alteration of thyroid function.