To develop an Italian expert consensus describing eczema–psoriasis overlap and guiding its clinical characterization and management.
Approach:
Design: An iterative, anonymous online Delphi consensus process informed by a literature search.
Participants: The study invited 131 Italian dermatologists with more than 5 years of experience managing psoriasis and atopic dermatitis.
Voting: Participants rated statements from 1 to 9; a mean score of at least 7 defined consensus approval, and more than 75% of ratings at or above 7 indicated high agreement.
Key Findings:
The panel reached agreement on 42 of 43 statements.
The consensus supports that eczema and psoriasis may coexist or occur sequentially, spontaneously or as drug-induced phenotype shifts.
It recommends considering risk factors for drug-induced forms when selecting treatment.
Interpretation:
The consensus provides expert-derived descriptions and management guidance for eczema–psoriasis overlap, while identifying areas of uncertainty requiring further clinical investigation.
Limitations:
The findings represent expert consensus rather than patient-level clinical evidence.
The panel consisted of dermatologists practicing in Italy, which may limit applicability to other settings.
Genetically predicted triglyceride levels were associated with higher odds of psoriasis, while genetically predicted total fatty acid levels were not, in a two-sample Mendelian randomization analysis.
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.
