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Here, we describe the case of a 75-year-old man who presented with a 3-year history of progressive dyspnea on exertion (classified as grade II/III on the modified Medical Research Council scale) and persistent dry cough. He had worked as a professional welder for 35 years, welding alloys, polishing weldments by sandblasting and steel blasting, and regularly performing isolation of fixed appliances with asbestos fibers.Treated in the primary care setting in the first year, the patient developed recurrent scaly skin lesions (exhibiting a lichenified/desquamative pattern) on the limbs, Raynaud’s phenomenon, sicca syndrome, and weight loss (5 kg). Physical examination revealed that he was breathing normally, with an SpO

Mixed pneumoconiosis due to silicates and hard metals associated with primary Sjogren's syndrome due to silica