{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,7,16]],"date-time":"2025-07-16T12:42:57Z","timestamp":1752669777683,"version":"3.37.3"},"reference-count":34,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2023,1,7]],"date-time":"2023-01-07T00:00:00Z","timestamp":1673049600000},"content-version":"vor","delay-in-days":128,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,5,22]],"date-time":"2022-05-22T00:00:00Z","timestamp":1653177600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2022,9,1]],"date-time":"2022-09-01T00:00:00Z","timestamp":1661990400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004336","name":"Novartis","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004336","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2022,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Patients with psoriasis have a high risk for multiple comorbid conditions. However, few studies have examined the association between psoriasis and severe and rare infections. This study reports the incidence of severe and rare infections (considered as rare in Denmark) among Danish patients with psoriasis, compared with the general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objectives<\/jats:title><jats:p>The objectives of this study were to assess the incidence and risk of severe and rare infections in Danish patients with psoriasis and the matched general population, and to compare this risk for patients with severe or mild psoriasis with that of the general population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data for individuals aged \u226518 years who were alive and resident in the source population were collected from the Danish National Patient Register between 1 January 1997 and 31 December 2018. Individuals with any of the investigated chronic infections prior to inclusion were excluded. Patients with psoriasis were matched (1 : 6) for age and sex with general population controls. Severe infections were defined as infections requiring treatment in a hospital setting and rare infections included HIV, hepatitis B and C, and tuberculosis infections. Incidence rates (IRs) were reported per 100 000 person-years of exposure. Severe psoriasis was defined according to previous or active use of systemic or biological treatment. Patients who never received biological and\/or systemic treatment were categorized as having mild psoriasis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 94 450 patients with psoriasis were matched with 566 700 controls. The respective IRs were higher for patients with any psoriasis compared with controls; IR 3104\u00b79 [95% confidence interval (CI) 3066\u00b76 to 3143\u00b77] and IR 2381\u00b71 (95% CI 2367\u00b76 to 2394\u00b76) for any infection, IR 3080\u00b76 (95% CI 3042\u00b75 to 3119\u00b73) and IR 2364\u00b74 (95% CI 2350\u00b79 to 2377\u00b79) for severe infections, and IR 42\u00b79 (95% CI 38\u00b789 to 47\u00b74) and IR 31\u00b78 (95% CI 30\u00b734 to 33\u00b73) for rare infections, respectively. Patients with severe psoriasis had higher IRs of severe or rare infections (IR 3847\u00b77, 95% CI 3754\u00b73 to 3943\u00b74) compared with patients with mild psoriasis and controls.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>As the severity of psoriasis increases, so does the risk of severe and rare infections. Therefore, clinicians should be aware of the increased risk of severe and rare infections in patients with severe psoriasis so that early investigation and treatment can be initiated.<\/jats:p><jats:p>What is already known about this topic? Few studies have looked at the incidence and prevalence of serious infections (associated with hospitalization) and rare infections including tuberculosis, hepatitis B and C, and HIV among patients with different severities of psoriasis.<\/jats:p><jats:p>What does this study add? Patients with psoriasis have an increased risk of severe and rare infections. Clinicians should be aware of the increased risk of severe and rare infections in patients with severe psoriasis so that early investigation and treatment can be initiated.<\/jats:p><\/jats:sec>","DOI":"10.1111\/bjd.21595","type":"journal-article","created":{"date-parts":[[2022,4,5]],"date-time":"2022-04-05T08:54:40Z","timestamp":1649148880000},"page":"353-363","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["A nationwide population-based cohort study of the incidence of severe and rare infections among adults with psoriasis in Denmark"],"prefix":"10.1093","volume":"187","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2950-3280","authenticated-orcid":false,"given":"Nikolai","family":"Loft","sequence":"first","affiliation":[{"name":"Department of Dermatology and Allergy Copenhagen University Hospital \u2013 Herlev and Gentofte Gentofte Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-9680","authenticated-orcid":false,"given":"Lone","family":"Skov","sequence":"additional","affiliation":[{"name":"Department of Dermatology and Allergy Copenhagen University Hospital \u2013 Herlev and Gentofte Gentofte Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Craig","family":"Richardson","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Vivek","family":"Trivedi","sequence":"additional","affiliation":[{"name":"Novartis Pharmaceuticals Corporation East Hanover NJ USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ivette","family":"Alarcon","sequence":"additional","affiliation":[{"name":"Novartis Pharma AG Basel Switzerland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8257-1816","authenticated-orcid":false,"given":"Alexander","family":"Egeberg","sequence":"additional","affiliation":[{"name":"Department of Dermatology Bispebjerg Hospital Copenhagen Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"286","published-online":{"date-parts":[[2022,9,1]]},"reference":[{"key":"2023010808101074100_bjd21595-bib-0001","doi-asserted-by":"crossref","first-page":"377","DOI":"10.1038\/jid.2012.339","article-title":"Global epidemiology of psoriasis: a systematic review of incidence and prevalence","volume":"133","author":"Parisi","year":"2013","journal-title":"J Invest Dermatol"},{"key":"2023010808101074100_bjd21595-bib-0002","doi-asserted-by":"crossref","first-page":"380","DOI":"10.1136\/bmj.333.7564.380","article-title":"Psoriasis and its management","volume":"333","author":"Smith","year":"2006","journal-title":"BMJ"},{"key":"2023010808101074100_bjd21595-bib-0003","doi-asserted-by":"crossref","first-page":"423","DOI":"10.1242\/dmm.009092","article-title":"Putting together the psoriasis puzzle: an update on developing targeted therapies","volume":"5","author":"Johnson-Huang","year":"2012","journal-title":"Dis Model Mech"},{"key":"2023010808101074100_bjd21595-bib-0004","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/s12955-017-0721-x","article-title":"How is disease severity associated with quality of life in psoriasis patients? 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