Clinical Scorecard: Italian Expert eDelphi Consensus on the Clinical Features and Treatment of Eczema–Psoriasis Overlap
At a Glance
Category
Detail
Condition
Eczema–psoriasis overlap, including coexisting or sequential atopic dermatitis and psoriasis and drug-induced phenotypic switches.
Key Mechanisms
The article describes shared immune mechanisms, including Th17/Th22 involvement, alongside the balance between Th2 and Th17 pathways.
Target Population
Patients with eczematous and psoriatic features occurring together or at different times, including during biologic treatment.
Care Setting
Clinical assessment and treatment selection in dermatology practice, informed by an Italian expert consensus developed by dermatologists at referral centres.
Key Highlights
An Italian eDelphi panel of 104 dermatologists reached consensus on 42 of 43 statements.
Eczema and psoriasis may coexist or occur sequentially, spontaneously or as drug-induced phenotypic switches.
The consensus addresses clinical presentation and management of eczema–psoriasis overlap.
Assessment of risk factors for drug-induced forms is emphasized during treatment selection.
The authors identify uncertainties requiring further clinical investigation.
Guideline-Based Recommendations
Diagnosis
Characterize whether eczematous and psoriatic features coexist or occur sequentially, and consider whether a phenotypic switch may be drug-induced.
Management
Use individualized treatment selection for patients with eczema–psoriasis overlap.
Assess risk factors for drug-induced forms when selecting treatment.
Monitoring & Follow-up
Risks
Biologic treatment may be associated with eczematous eruptions in patients treated for psoriasis or psoriasiform responses in patients treated for atopic dermatitis.
Patient & Prescribing Data
Patients with atopic dermatitis and psoriasis features that coexist or arise sequentially, including patients experiencing possible drug-induced phenotypic switches.
The consensus supports individualized treatment selection and assessment of risk factors for drug-induced forms; the supplied article text provides no specific drug regimens or dosing.
Clinical Best Practices
Consider eczema–psoriasis overlap when eczematous and psoriatic lesions occur together or at different times.
Consider spontaneous and drug-induced phenotypic switches in clinical characterization.
Include risk-factor assessment for drug-induced forms in treatment selection.
Recognize that the consensus identifies areas of uncertainty requiring additional clinical investigation.
The expanded indication is supported by pharmacokinetic, safety, tolerability, exploratory efficacy, and long-term safety data from studies in children aged 2 to 5 years.
