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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 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.
Conclusion
The study discusses treatment-associated phenotype switching in patients with psoriasis and atopic dermatitis.