Objective:

To describe persistent, treatment-associated phenotype switching between psoriasis and atopic dermatitis.

Approach:

Key Findings:

• 101 patients developed eczematous features while receiving treatment for psoriasis.
• 47 patients developed psoriasiform disease while receiving treatment for atopic dermatitis.
• Psoriasis-to-eczematous switching was most often documented during treatment with interleukin-17 inhibitors (58% of cases).
• Atopic dermatitis-to-psoriasiform switching occurred primarily during treatment with dupilumab (91.5% of cases).
• Clinical severity scores improved following therapeutic adjustment in both groups.

Interpretation:

Limitations:

• Retrospective observational design.
• Lack of a comparator population.
• Potential selection bias and incomplete data capture.
• Absence of systematic histopathologic or molecular confirmation.
• Predominantly Caucasian cohort may limit generalizability.

Conclusion:

Sustained phenotype switching should be considered in patients developing opposing features during targeted therapy.

Sources:

• Journal of the European Academy of Dermatology and Venereology
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