Concomitant Interstitial Lung Disease With Psoriasis

Abstract

Interstitial lung disease is occasionally reported in patients with psoriasis as drug-induced pneumonitis secondary to concomitant use of immunosuppressants in most cases. Although few cases have been reported describing the simultaneous existence of psoriasis and interstitial pneumonia, there are no reports that clearly show their direct association. A 55-year-old male known case of psoriasis and hypertension presented to the emergency department with complaints of pain and weakness of bilateral upper limbs following an episode of seizure and shortness of breath on exertion for one year. Following workup, the patient was diagnosed to have interstitial lung disease. There was no history of any immunosuppressant or use of biologics. So, immune dysfunction triggered by psoriasis might have caused the lung fibrotic changes. Careful monitoring of lung and skin lesions is vital for diagnosing psoriasis-associated pneumonia.

Keywords: idiopathic pulmonary fibrosis (ipf); interstitial lung disease; non-specific interstitial lung disease (nsip); psoriasis; usual interstitial pneumonia (hip).

Figure 1. (A) A well-defined scaly plaque of psoriasis and (B) well-defined thick adherent silvery scales in the scalp

Figure 2. HRCT thorax showing heterogenous subpleural and basal predominant honeycombing with traction bronchiectasis in the bilateral lung

HRCT: High-resolution computed tomography.

Figure 3. (A) 100X magnification, H&E section shows acanthosis, parakeratosis with neutrophils, and thinning of suprapapillary plates. (B) 400X magnification, H&E section shows parakeratosis with neutrophils and perivascular lymphocytic infiltrate.

H&E: Hematoxylin and eosin stain.