Iskandar IYK, Lunt M, Thorneloe RJ, et al. - According to this prospective cohort study, people with psoriasis who abuse alcohol or are obese have a poor response to therapy, which need lifestyle behaviour change interventions and support as part of routine clinical care. Interventions aimed at preventing, detecting, and managing alcohol abuse in people with psoriasis are required to reduce negative health consequences and improve treatment response.

• A total of 266 patients with psoriasis (biologic cohort, n = 134; conventional systemic cohort, n = 132) were involved.

• The median (interquartile range) Psoriasis Area and Severity Index (PASI) for the entire cohort improved from 13 (10·0–18·3) at baseline to 3 (1·0–7·5) during follow-up.

• A higher CAGE (Cut down, Annoyed, Guilty, Eye opener) score [regression coefficient: 1·40, 95% confidence interval (CI) 0·04–2·77]; obesity (1·84, 95% CI 0·48–3·20); and receiving a conventional systemic rather than a biologic therapy (4·39, 95% CI 2·84–5·95) were significantly correlated with poor response to treatment; while a higher baseline PASI (–0·83, 95% CI –0·92 to –0·74) was related to a better response to treatment.