Chest radiography and serum KL-6 test in psoriasis patients may help detect ILD: Study

A new study published in the journal of BMC Pulmonary Medicine showed that 10% of psoriasis patients would have interstitial lung disease (ILD), which is linked to psoriasis. The most common kind of psoriasis among the 11,631 patients examined was psoriasis vulgaris (88.5%), which was followed by guttate psoriasis (3.9%), psoriatic arthritis (3.3%), generalized pustular psoriasis (1.3%), and other subtypes.

In addition to a hereditary susceptibility, psoriasis has been associated with aberrant immune function impacted by a number of internal and environmental variables. Dust exposure, medication side effects, and inflammatory conditions like rheumatoid arthritis can all cause interstitial lung disease (ILD).

Psoriasis may be linked to ILD since it is an autoimmune condition. Reports describing the connection between psoriasis and ILD are scarce nonetheless. Even though psoriasis is an autoimmune condition, nothing is known about the possible link between it and interstitial lung disease. The purpose of this study was to establish a novel conceptual framework of "ILD associated with psoriasis" and examine the prevalence and clinical characteristics of ILD in psoriasis patients.

After excluding patients with additional comorbidities that resulted in ILD and the individuals lacking chest imaging before using methotrexate or biologics, a retrospective study of 117 psoriasis patients was carried out. In order to prevent drug-induced ILDs, ILDs were detected based on the clinical characteristics and radiologic findings of the patients prior to the start of therapies that may be linked to ILD. The period of time from chest imaging (ILD diagnosis) to death from any cause was known as overall survival (OS).

ILD was found in 12 (10%) psoriasis patients, 6 psoriasis vulgaris patients, and 6 psoriatic arthritis patients. Out of 12 patients, 3 had never smoked. Those with ILD had higher serum Krebs von den Lungen-6 (KL-6) levels than those without ILD. The most common CT result was the indeterminate for typical interstitial pneumonia (UIP) pattern. An example case's lung biopsy sample showed comparable indeterminate for UIP.

Only 5 individuals experienced ILD progression over a median observation time of 8.9 years, and there were no instances of respiratory failure or ILD-related deaths, indicating generally favorable prognoses. Overall, this study recommend that screening for ILD might benefit from the use of chest radiography and a serum KL-6 test at the time of psoriasis diagnosis. 

Source:

Kanaji, N., Misaki, N., Murota, M., Iwata, M., Ishikawa, R., Yamamura, K., Tanaka, H., Yokota, N., Fujimoto, S., Yajima, T., Dobashi, H., Shimada, H., Wakiya, R., Watanabe, N., Inoue, T., Mizoguchi, H., Komori, Y., Kojima, K., Kadowaki, N., & Dainichi, T. (2024). Prevalence and clinical features of interstitial lung disease in patients with psoriasis. In BMC Pulmonary Medicine (Vol. 24, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12890-024-03450-7