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Background: Hidradenitis suppurativa (HS) is a chronic, debilitating, dermatological disease that causes substantial psychosocial impediments with increased suicidal risk. Yet data on psychiatric comorbidity in HS have not been sufficiently elucidated in population‐based studies. The current study sought to investigate the association between HS and schizophrenia, a major psychiatric disease, in a nationwide population‐based study in Israel. Methods: Data mining was performed on the database of Clalit Health Services (CHS), the largest managed healthcare company in Israel. Patients diagnosed with HS (n = 4191) were examined and compared to age‐ and sex‐matched controls (n = 20 941). The association between HS and schizophrenia was assessed via multivariate binary logistic regression, adjusting for demographic factors and smoking status. Results: The analysis revealed a tenfold increase in the prevalence of schizophrenia in HS patients compared to controls (1.4% and 0.4%, respectively, P < 0.001). In multivariate analysis, HS was found to be associated with schizophrenia (OR 1.44, 95% CI 1.01–2.07, P < 0.05). Conclusions: Hidradenitis suppurativa is associated with schizophrenia. Screening for severe mental illness during the assessment of patients with HS is of great importance, as comorbid psychiatric disorders may affect treatment outcomes. Linked Commentary: F. Poot. J Eur Acad Dermatol Venereol 2020; 34: 442–443. https://doi.org/10.1111/jdv.16260. [ABSTRACT FROM AUTHOR]

Background: Psoriasis is a common chronic inflammatory skin disease associated with a heavy burden of morbidity, disability and cost. The occurrence of the disease in Israel has not been previously investigated. Objectives: To provide standardized estimates of trends in psoriasis incidence, prevalence and mortality among patients in Israel between 2011 and 2017. Methods: Using electronic health records from Clalit Health Services, the largest nationwide public health provider in Israel, we conducted a population‐based study investigating trends in the annual incidence and prevalence of psoriasis between the years 2011 and 2017. We report age‐ and sex‐adjusted rates, using the standard European population as a reference. Results: We identified 71 094 incident psoriasis cases. The mean (SD) age of onset was 42.4 (21.0) years with a bimodal distribution, peaking in the early '30s and early '60s. Late‐onset psoriasis, occurring after 40 years of age, accounted for 51.1% of incident cases. The annual psoriasis incidence rate was constant throughout the study period (280/100 000 person‐years). Psoriasis prevalence rose from 2.5% in 2011 to 3.8% in 2017. Conclusions: Psoriasis prevalence is increasing in Israel, although its incidence is stable. Clinicians and policymakers should plan to address the growing demands in the clinical, economic and societal burden of psoriasis. [ABSTRACT FROM AUTHOR]

Background: Numerous studies have indicated that comorbid anxiety and depression are associated with a more severe course of illness. Yet generally, the study of the effect of psoriasis on patients' mental health has considered anxiety and depression to be separate states. Objective: To measure the association between psoriasis and anxiety, depression and anxiety–depression co‐occurrence among patients according to their socioeconomic statuses (SES). Methods: A nationwide population‐based study of psoriasis patients and age and gender frequency‐matched controls (n = 255 862) was designed. Diagnostic data were obtained from Clalit Health Services, the largest managed care organization in Israel. This database was established using continuous real‐time input from healthcare providers, pharmacies, medical care facilities and administrative computerized operating systems. Results: After controlling for demographic and clinical variables, psoriasis was associated with anxiety (OR 1.11, 95% CI 1.01–1.23, P < 0.05), depression (OR 1.17, 95% CI 1.08–1.26, P < 0.001), and anxiety and depression co‐occurrence (OR 1.32, 95% CI 1.21–1.45, P < 0.001) among patients with low SES, yet was associated only with anxiety (OR 1.15 95% CI 1.04–1.27, P < 0.001) but not depression or comorbid anxiety–depression among patients with high SES. Survival analyses indicated that between the ages of 40 and 60, the cumulative probability of psoriasis patients with low SES to suffer from anxiety, depression and their co‐occurrence inclined more sharply with age as compared to psoriasis patients with high SES. Conclusions: As psoriasis patients with low SES are prone to suffer from more severe courses of anxiety and depression, the choice of treatment of psoriasis should address the SES as well as the underlying psychiatric disease. [ABSTRACT FROM AUTHOR]

Summary: Background: Chronic urticaria (CU) carries many risk factors for osteoporosis, but data on the relationships between CU and osteoporosis are lacking. Objectives: To evaluate the association between CU and osteoporosis in a large community‐based study. Methods: A nationwide observational longitudinal cohort study was conducted. CU was defined as four pairs of urticaria diagnoses; each pair was recorded within a period of 6 weeks and was registered by physicians in a primary‐care setting. Patients with CU and their age‐ and sex‐ matched controls were followed for the incidence of osteoporosis and other laboratory data between 2002 and 2017. Data regarding systemic steroid exposure and other relevant risk factors for osteoporosis were obtained. Analyses of risk for osteoporosis were performed in Cox regression models adjusted for age, sex, exposure to systemic corticosteroids, obesity, smoking and hyper‐ and hypothyroid disease. Results: The study included 11 944 patients with CU and 59 829 controls. During the study's observation period, 1035 (8·7%) patients with CU were diagnosed with osteoporosis, compared with 4046 (6·8%) controls. The adjusted multivariate analysis demonstrated that CU was significantly associated with a higher risk for osteoporosis (hazard ratio 1·23, 95% confidence interval 1·10–1·37, P < 0·001). Conclusions: CU may impose a risk for osteoporosis. Appropriate targeted screening should be considered. What's already known about this topic? Chronic urticaria (CU) is associated with the chronic inflammatory process. What does this study add? In this nationwide cohort study, we determined that patients with CU had an increased risk for osteoporosis compared with the general population in Israel. Linked Comment: Egeberg. Br J Dermatol 2019; 180:979. Plain language summary available online Respond to this article [ABSTRACT FROM AUTHOR]