Interstitial lung disease in psoriasis: A systematic review and meta-analysis

Psoriatic disease is associated with several extra-cutaneous complications, including cardiovascular disease and type 2 diabetes. Whether psoriatic disease is associated with interstitial lung disease (ILD) remains uncertain. The aim of this study was toquantify the prevalence of ILD overall and across specific subtypes of psoriatic disease.

We systematically searched PubMed, Embase, and Scopus for original studies reporting the prevalence of ILD in adults with psoriatic disease. Pooled prevalence estimates were calculated using proportional random-effects meta-analysis, with subgroup analyses stratified by factors including psoriatic disease type, sex, and smoking history. Random-effects meta-regression was conducted to examine the influence of age and disease duration.

Of 863 records screened, 11 studies were included. The pooled ILD prevalence in any psoriatic disease was 3.6% (95% CI: 2.1-5.0%). Meta-regression indicated that ILD prevalence increased by 0.19 percentage points per year (95% CI: 0.16-0.22) from approximately 38 years of age. Subgroup analysis showed ILD prevalences of 2.4% (95% CI: 1.1-3.6%) in psoriasis vulgaris, 5.7% (95% CI: 2.5-8.9%) in psoriatic arthritis, and 8.4% (95% CI: 6.4-10.4%) in generalized pustular psoriasis (GPP). ILD prevalence was 1.2% (95% CI: 0.1-2.2%) in never-smokers versus 6.7% (95% CI: 2.3-11.1%) in ever-smokers.

ILD may represent a clinically relevant comorbidity in patients with psoriatic disease, particularly psoriatic arthritis and GPP. This increased prevalence may reflect chronic systemic inflammation and exposures such as medications and cigarette smoke. Further research is needed to elucidate the underlying mechanisms and to assess whether early detection and targeted interventions can improve outcomes.