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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.
Clinical Report: Psoriasis–AD Switching May Mimic Treatment Failure
Overview
A retrospective cohort study identified persistent phenotype switching between psoriasis and atopic dermatitis during systemic or biologic therapy. The study involved 148 patients across multiple countries and highlighted the need for recognition of this phenomenon.
Background
Understanding the relationship between psoriasis and atopic dermatitis is crucial for effective management, as treatment-associated phenotype switching can complicate clinical decision-making. This study describes how systemic therapies can lead to unexpected changes in disease presentation.
Data Highlights
Switch Type
Percentage of Cases
Mean Treatment Duration (months)
Psoriasis to Eczematous
58%
17
Atopic Dermatitis to Psoriasiform
91.5%
18
Key Findings
101 patients developed eczematous features while on psoriasis treatment.
47 patients developed psoriasiform disease while on atopic dermatitis treatment.
Interleukin-17 inhibitors were most associated with psoriasis-to-eczematous switching.
Dupilumab was linked to 91.5% of atopic dermatitis-to-psoriasiform switches.
Janus kinase inhibitors were the most common management strategy following phenotype switching.
Clinical severity scores improved significantly after treatment modification in both groups.
Clinical Implications
Physicians should consider the possibility of sustained phenotype switching when patients exhibit opposing features during targeted therapy.
Conclusion
The study highlights the importance of recognizing treatment-associated phenotype switching in psoriasis and atopic dermatitis.
A randomized clinical trial found that a team-based connected health model achieved equivalent improvements in atopic dermatitis severity and symptoms compared with conventional in-person care over 12 months.
