Psoriasis–AD Switching May Mimic Treatment Failure

Recognizing sustained switches between the two diseases can prevent premature discontinuation of effective biologics and point toward Janus kinase inhibitors, a 148-patient cohort suggests.

By
Andrea Surnit
June 15, 2026
4 min

Conexiant

Overview

A multinational retrospective cohort study found that persistent phenotype switching between psoriasis and atopic dermatitis may be misinterpreted as treatment failure. The study included 148 patients across 17 dermatology centers.

Background

Understanding the dynamics between psoriasis and atopic dermatitis is crucial for effective management, as misclassification can lead to inappropriate treatment adjustments. This study addresses treatment-associated phenotype switching during systemic or biologic therapies.

Data Highlights

Switch Type	Number of Patients	Common Treatments
Psoriasis to Eczematous	101	IL-17 inhibitors (58%)
Atopic Dermatitis to Psoriasiform	47	Dupilumab (91.5%)

Key Findings

101 patients with psoriasis developed eczematous features during treatment.
47 patients with atopic dermatitis developed psoriasiform disease while on treatment.
Switching from psoriasis to eczematous features was most common with IL-17 inhibitors.
Dupilumab was the primary treatment associated with atopic dermatitis to psoriasiform switching.
Janus kinase inhibitors were frequently used for managing switched phenotypes.
Clinical severity scores improved following treatment modifications in both groups.

Clinical Implications

Physicians should consider the possibility of sustained phenotype switching when patients exhibit opposing features during targeted therapy. This recognition may prevent misclassification as treatment failure and facilitate appropriate therapeutic adjustments.