Psoriasis (pulmonary manifestations)

Pulmonary manifestations of psoriasis is uncommon and only thought to represent a small percentage of patients. They can include:

• interstitial lung disease ¹

  • only thought to affect around 2% of patients with psoriasis

  • may be seen as ground-glass and/or irregular linear (reticular) opacities in the bilateral lower lobes

• pulmonary nodules

  • occasionally reported ²

A number of other pulmonary manifestations have also been reported to be associated with psoriasis patients. Whilst the pathophysiological mechanism is not fully understood, it is believed the immune response secondary to systemic inflammation in psoriasis leads to these associated manifestations³. Notably:

• chronic obstructive pulmonary disease (COPD)^3-5

  • Severity of psoriasis correlates with risk of developing COPD

  • Increased age was associated with increased risk of COPD

  • In one Taiwanese study, men with psoriasis had increased risk of COPD

  • Increased COPD rates in psoriasis patients may be due to correlations with increased smoking rates in psoriasis and COPD patients³

• Asthma^3,6

  • Some observational studies suggest increased risk of asthma in children with psoriasis

  • Older patients with psoriasis have increased risk of asthma

• Obstructive Sleep Apnea⁷

  • Some articles suggest psoriasis symptoms of pruritus and pain may disrupt sleep, consequently activating autonomic activity

  • Hypoxia may lead to oxygen stress resulting in activation of the inflammatory pathway.

• Pulmonary Arterial Hypertension⁸

  • Pulmonary arterial hypertension is only seen in patients with severe psoriasis. Increased risk is not seen in cases of mild psoriasis.

Pulmonary changes may also occur in some patients treated for psoriasis with medications such as methotrexate etc.

See also

• psoriasis

• psoriatic arthritis