Shortness of Breath in Psoriasis May Be Linked to Reduced FEV1

According to a recent cross-sectional population study published in the British Journal of Dermatology, patients with psoriasis present with decreased forced expiratory volume in 1 second (FEV₁) and FEV₁/forced vital capacity (FVC), with no differences in FVC.

Psoriasis is a chronic inflammatory systemic disease associated with several comorbid conditions, including chronic obstructive pulmonary disease and asthma.

Recurrent respiratory infections, including pneumonia, have been observed as well. However, studies of pulmonary function are limited, driving a need for additional research.

Subjects were collected from the Danish General Suburban Population Study. The sample included 20,422 adults, including 1153 patients with psoriasis and 19,249 control patients. Psoriasis was determined by self-report. Pulmonary function tests were performed in all participants using handheld spirometers. In addition, clinical interviews were conducted to screen for psoriasis, shortness of breath, and history of pneumonia.

FEV₁, reported as percentages of reference value (93.2%±16.8% vs 94.9%±16.4%; P <.001), and FEV₁/FVC (0.76±0.09 vs 0.77±0.08; P < .0001) were decreased in patients with psoriasis compared with in control patients. When adjusted for smoking, FEV₁ differences remained statistically significant (delta value, −1.6; 95% CI, −2.5% to −0.6%; P =.002), and a higher percentage of patients with psoriasis evidenced FEV₁/FVC ratios <0.70 (21.0% vs 16.7%; P <.001) with an odds ratio of 1.19 (95% CI, 1.02-1.38; P =.02).

Data also showed increased mean body mass index and high-sensitivity C-reactive protein, as well as higher prevalence of pneumonia within the last 10 years, frequent shortness of breath, and smoking, among patients with psoriasis.

“To our knowledge these are the first population-based data on pulmonary function in patients with psoriasis,” the authors wrote. “[O]ur results…are important by suggesting that psoriasis is independently associated with a small but significant reduction of FEV1. Although the magnitude of this reduction was small and of questionable clinical significance, it is possible that this may contribute to increased shortness of breath in subjects with psoriasis.”

Reference

Hansen PR, Isaksen JL, Jemec GB, et al. Pulmonary function in subjects with psoriasis: A cross-sectional population study [published online March 11, 2018]. Br J Dermatol. doi: 10.1111/bjd.16539