Oshita Hideto, Ogata Misato, Inoue Asami, Sano Yuka, Yoshioka Koji, Ikegami Yasuhiko, Yamaoka Naoki
Department of Respiratory Medicine, Federation of National Public Service and Affiliated Personnel Mutual Aid Associations, Yoshijima Hospital.
Arerugi. 2023;72(5):485-489. doi: 10.15036/arerugi.72.485.
A 72-year-old woman who was undergoing treatment for bronchial asthma and psoriasis vulgaris experienced malaise three months earlier and visited our hospital on account of abnormal lung shadows. Chest computed tomography revealed ground-glass opacities in the peripheral lung fields and eosinophilia in the bronchoalveolar lavage fluid, which suggested eosinophilic pneumonia. Antineutrophil cytoplasmic antibody was negative. Her lower limbs had multiple palpable papules mixed with well-treated psoriasis and the histopathology of the skin biopsy revealed eosinophil infiltration around small vessels, suggesting the occurrence of eosinophilic granulomatosis with polyangiitis (EGPA). We were able to evaluate minor skin lesions mixed with psoriasis through collaboration between the pulmonologist and the dermatologist. In the diagnosis of EGPA, it is important to carefully examine the whole body and not overlook minor findings before starting steroids.
