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How Psoriatic Disease May Impact the Health of Your Lungs

What we do and don’t know about the association between psoriasis, psoriatic arthritis, and respiratory disease.

How Psoriatic Disease May Impact the Health of Your Lungs

Psoriasis and psoriatic arthritis—collectively known as psoriatic disease—are associated with a number of serious health conditions. Cardiovascular disease, type 2 diabetes, obesity, psychiatric and mood disorders, and other inflammatory autoimmune disorders are some of the well-known examples.

Psoriatic disease is also associated with a number of diseases and disorders that affect the lungs. These include:

  • Asthma. People with psoriasis, especially people who are older, are at an increased risk of having asthma, a chronic condition of the respiratory system characterized by inflammation of the airways.
  • COPD. Chronic obstructive pulmonary disease refers to a collection of diseases that make it difficult to breathe. The two main types are chronic bronchitis and emphysema. People with psoriasis are at a greater risk of having COPD.
  • Sarcoidosis. This is an inflammatory disease characterized by the formation of small nodules called granulomas. Granulomas can form in the lungs, lymph nodes, and other organs. The cause is unknown, but research shows people with psoriasis are at a higher risk.
  • Lung cancer. Research has shown that people with psoriasis, and especially people with severe psoriasis, have a slightly higher risk of certain cancers, including lung cancer. A significant percentage of psoriasis patients are also smokers, and smoking is the number one risk factor for lung cancer.

The association between these respiratory disorders and psoriatic disease is not fully understood. More research is needed to understand the connection and the extent of the risk. However, there are steps you can take to prevent lung disease and keep yourself healthy.

As mentioned above in the bullet point on lung cancer, a significant number of people with psoriasis smoke. Smoking contributes to COPD, lung cancer, and many other serious health conditions, including cardiovascular disease. If you smoke, quitting can help lower your risk of disease and improve your overall health. If you smoke and have psoriasis and/or psoriatic arthritis, quitting my help you have better control over your symptoms and respond better to treatment.

It is also worth mentioning that some medications that are used to treat psoriasis can also impact the health of the lungs. Lung damage is a potential side effect for methotrexate, an immunosuppressant drug that is sometimes used to treat psoriasis and psoriatic arthritis.

Infections, including respiratory infections, are a potential side effect of some biologic therapies used to treat psoriasis and psoriatic arthritis. Biologic therapies act on the immune system to reduce inflammation.

Any time you are starting a therapy for psoriasis or psoriatic arthritis, talk to your healthcare provider about the possible side effects and what to do if you experience a side effect. You should also discuss:

  • Any existing health conditions you have
  • Your vaccination status, and if you need any vaccinations or boosters
  • Your medical history, including any history of infections and any past surgeries
  • Your family’s medical history
  • Smoking and alcohol use
  • All medications you take, including medications for other conditions, over-the-counter medications, and supplements

Remember that psoriatic disease is a different experience for everyone. Your best source of information about your health is your healthcare provider.

Medically reviewed in December 2020.

Sources:
National Psoriasis Foundation. "Understanding Psoriatic Disease."
Maria de Fatima Santos Paim de Oliveira, Bruno de Oliveira Rocha, and Gleison Vieira Duarte. "Psoriasis: classical and emerging comorbidities." Anais Brasileiros de Dermatologia, 2015. Vol. 90, No. 1.
M. Alan Menter, April W. Armstrong, et al. "Common and Not-So-Common Comorbidities of Psoriasis." Seminars in Cutaneous Medicine and Surgery, 2018. Vol. 37, No. 2S.
National Psoriasis Foundation. "Related Conditions."
The Psoriasis and Psoriatic Arthritis Alliance. "Psoriasis and lung disease."
Genta Ishikawa, Sakshi Dua, et al. "Concomitant Interstitial Lung Disease with Psoriasis." Canadian Respiratory Journal, 2019.
Jian Wang, Rui Ke, et al. "Association between psoriasis and asthma risk: A meta-analysis." Allergy and Asthma Proceedings, 2018. Vol. 39, No. 2.
MedlinePlus. "Asthma."
Xin Li, Lingjun Kong, et al. "Association between Psoriasis and Chronic Obstructive Pulmonary Disease: A Systematic Review and Meta-analysis." PLOS ONE, 2015. Vol. 10, No. 12.
MedlinePlus. "COPD."
Usman Khalid, Gunnar Hilmar Gislason and Peter Riis Hansen. "Sarcoidosis in Patients with Psoriasis: A Population-Based Cohort Study." PLOS ONE, 2014. Vol. 9, No. 10.
Cleveland Clinic. "Sarcoidosis."
Craig A. Elmets, Craig L. Leonardi, et al. "Joint AAD-NPF guidelines of care for the management and treatment of psoriasis with awareness and attention to comorbidities." Journal of the American Academy of Dermatology, 2018. Vol. 80, No. 4.
Giampiero Favato. "High Incidence of Smoking Habit in Psoriatic Patients." American Journal of Medicine, 2008. Vol. 121, No. 4.
Centers for Disease Control and Prevention. "Smoking & Tobacco Use."
Luigi Naldi. "Psoriasis and smoking: links and risks." Psoriasis: Therapy and Targets, 2016. Vol. 6.
MedlinePlus. "Methotrexate."
UpToDate. "Patient education: Psoriatic arthritis (Beyond the Basics)."
UpToDate. "Treatment of psoriasis in adults."

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