Skin disorders and interstitial lung disease: Part II—The spectrum of cutaneous diseases with lung disease association - 16/03/23

Doi : 10.1016/j.jaad.2022.09.051

Lydia Ouchene, MD ^a, Anastasiya Muntyanu, MD ^a, Deborah Assayag, MD ^b, Èvicka Veilleux ^c, Andy Abril, MD ^d, Giovanni Ferrara, MD, PhD ^e, Elaine Yacyshyn, MD ^f, Christian A. Pineau, MD ^g, Elizabeth O'Brien, MD ^a, Murray Baron, MD ^g, Mohammed Osman, MD, PhD ^f, Robert Gniadecki, MD, PhD ^h, Elena Netchiporouk, MD, MSc ^a,^⁎
^a Division of Dermatology, McGill University Health Centre, Montréal, Québec, Canada
^b Division of Pulmonary Medicine, McGill University Health Centre, Montréal, Québec, Canada
^c Department of Medicine, McGill University, Montreal, Québec, Canada
^d Division of Rheumatology, Mayo Clinic, Jacksonville, Florida
^e Division of Pulmonary Medicine, University of Alberta, Edmonton, Alberta, Canada
^f Division of Rheumatology, University of Alberta, Edmonton, Alberta, Canada
^g Division of Rheumatology, McGill University Health Centre, Montréal, Québec, Canada
^h Division of Dermatology, University of Alberta, Edmonton, Alberta, Canada

^∗Correspondence to: Elena Netchiporouk, MD, MSc, Division of Dermatology, Department of Medicine, McGill University Health Centre, 1650 Ave Cedar, Montréal, Québec H3G 1A4, Canada.Department of MedicineDivision of DermatologyMontreal General Hospital1650 Ave CedarMontrealQuébecH3G 1A4Canada

Abstract

Part 2 of this 2-part CME introduces dermatologists to noninfectious inflammatory skin diseases associated with pulmonary involvement. In many cases, dermatologists may be the first physicians recognizing respiratory complications associated with these diagnoses. Because pulmonary involvement is often the leading cause of morbidity and mortality, dermatologists should be comfortable screening and monitoring for lung disease in high-risk patients, recognizing cutaneous stigmata of lung disease in these patients and referring to pulmonary specialists, when appropriate, for prompt treatment initiation. Some treatments used for skin disease may not be appropriate in the context of lung disease and hence, choosing a holistic approach is important. Interstitial lung disease and pulmonary hypertension are the most common pulmonary complications and a significant cause of mortality in autoimmune connective tissue diseases, especially systemic sclerosis, dermatomyositis, and mixed connective tissue disease. Pulmonary complications, notably interstitial lung disease, are also common and life-threatening in sarcoidosis and vasculitis, while they are variable in neutrophilic and autoimmune blistering diseases.

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Key words : ANCA vasculitis, bronchiolitis obliterans, dermatomyositis, interstitial lung disease, high-resolution computed tomography, hypocomplementemic urticarial vasculitis syndrome, mixed connective tissue disease, neutrophilic dermatoses, paraneoplastic pemphigus, pulmonary arterial hypertension, pulmonary function tests, pulmonary hypertension, sarcoidosis, scleroderma, screening, systemic lupus erythematosus, systemic sclerosis, treatment, vasculitis

Abbreviations used : ANCA, AAV, ASS, BO, DLCO, DM, EGPA, GPA, HRCT, ILD, KD, MCTD, MPA, MTX, PFT, PAH, PH, SLE, SS, SSc, U1RNP

Plan

Systemic lupus erythematosus and mixed connective tissue disease

Autoimmune blistering diseases

Neutrophilic dermatoses

	Funding sources: None.
	IRB approval status: Not applicable.
	Consent for the publication of all patient photographs and medical information was provided by the authors at the time of article submission to the journal stating that all patients gave consent for their photographs and medical information to be published in print and online and with the understanding that this information may be publicly available.
	Date of release: April 2023.
	Expiration date: April 2026.
	Reprints not available from the authors.