Prevalence of periapical abscesses in psoriasis patients: a retrospective cross-sectional study

Objective: This study was performed to assess the prevalence of acute periapical abscesses (PAs) in patients with psoriasis and to determine whether this relationship remains after adjusting for related systemic, behavioral, and treatment-related confounders. Methods: A retrospective hospital-based analysis of 2,108,676 patients was conducted using de-identified clinical data. Diagnoses of psoriasis and acute PA without sinus involvement were identified using standardized coding. The association between psoriasis and acute PAs was assessed using odds ratios (ORs) with 95% confidence intervals (CIs). Multivariable logistic regression analyses were performed to adjust for diabetes, nicotine dependence, alcohol related disorders, and biologic therapy use. Results: Among 16,084 patients with psoriasis, 224 were diagnosed with acute PAs. Psoriasis was associated with a significantly higher prevalence of acute PAs than in the overall hospital population (OR, 2.21; 95% CI, 1.94-2.53; p < 0.0001). This association remained statistically significant after adjustment for diabetes (OR, 1.40), nicotine dependence (OR, 1.31), alcohol related disorders (OR, 1.89), and biologic therapy use (OR, 1.77). Female patients and white patients with psoriasis exhibited a higher prevalence of acute PAs compared with other demographic groups. Conclusions: Psoriasis is independently associated with an increased risk of acute PAs, even after accounting for common medical and behavioral risk factors. Greater awareness among clinicians and closer collaboration between dermatology and oral healthcare providers can facilitate earlier diagnosis and preventive treatment.