In this article, the definition of patients with severe psoriasis as those needing systemic drugs raises the question whether treatment itself may be linked to early mortality. The journal article cited in the story indicates that some systemic treatments may be less toxic than others, but I found nothing to refute the hypothesis that mortality might be due to adverse reactions to the medication.

David Harding
Warrenville, Ill.

The reader is correct that the study did not specifically look at whether the medications, and not the disease, could be responsible. Researchers did find early mortality differences between patients on different medications. —Editors