Skin disorders and interstitial lung disease: Part II-The spectrum of cutaneous diseases with lung disease association

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.

Keywords: ANCA vasculitis; bronchiolitis obliterans; dermatomyositis; high-resolution computed tomography; hypocomplementemic urticarial vasculitis syndrome; interstitial lung disease; 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.