Managing the Overlap: Therapeutic Approaches in Patients with Concomitant Psoriasis and Atopic Dermatitis—A Case Series
Abstract
1. Introduction
2. Materials and Methods
3. Case Series
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Abbreviations
PSO | Psoriasis |
AD | Atopic dermatitis |
PSO-AD | Psoriasiform dermatitis |
Th-1 | T-helper 1 |
Th-2 | T-helper 2 |
JAK-i | Janus Kinase Inhibitors |
PGA | Physician Global Assessment |
BSA | Body Surface Area |
DLQI | Dermatology Life Quality Index |
References
- Tsai, Y.C.; Tsai, T.F. Overlapping Features of Psoriasis and Atopic Dermatitis: From Genetics to Immunopathogenesis to Phenotypes. Int. J. Mol. Sci. 2022, 23, 5518. [Google Scholar] [CrossRef] [PubMed]
- Guttman-Yassky, E.; Krueger, J.G. Atopic dermatitis and psoriasis: Two different immune diseases or one spectrum? Curr. Opin. Immunol. 2017, 48, 68–73. [Google Scholar] [CrossRef] [PubMed]
- Bardazzi, F.; Pileri, A.; Clarizio, G.; Pilipenko, A.; Loi, C.; Sacchelli, L.; Abbenante, D. Psoriasis dermatitis: A new entity or a different phenotypic expression of psoriasis and atopic dermatitis? Ital. J. Dermatol. Venerol. 2024, 159, 166–173. [Google Scholar] [CrossRef] [PubMed]
- Cunliffe, A.; Gran, S.; Ali, U.; Grindlay, D.; Lax, S.J.; Williams, H.C.; Burden-Teh, E. Can atopic eczema and psoriasis coexist? A systematic review and meta-analysis. Skin. Health Dis. 2021, 1, e29. [Google Scholar] [CrossRef] [PubMed]
- Kim, J.E.; Lee, J.; Huh, Y.J.; Kim, K.; Chaparala, V.; Krueger, J.G.; Kim, J. Genomic Profiling of the Overlap Phenotype Between Psoriasis and Atopic Dermatitis. J. Investig. Dermatol. 2024, 144, 43–52.e6. [Google Scholar] [CrossRef] [PubMed]
- Trave, I.; Salvi, I.; Burlando, M.; Cozzani, E.; Parodi, A. “De Novo” Psoriasis and Relapse of Psoriasis Induced by Dupilumab: Three New Cases and Review of the Literature. J. Clin. Med. 2023, 12, 6291. [Google Scholar] [CrossRef] [PubMed]
- Czarnowicki, T.; He, H.; Krueger, J.G.; Guttman-Yassky, E. Atopic dermatitis endotypes and implications for targeted therapeutics. J. Allergy Clin. Immunol. 2019, 143, 1–11. [Google Scholar] [CrossRef] [PubMed]
- Chen, J.; Li, C.; Li, H.; Yu, H.; Zhang, X.; Yan, M.; Guo, Y.; Yao, Z. Identification of a TH 2-high psoriasis cluster based on skin biomarker analysis in a Chinese psoriasis population. J. Eur. Acad. Dermatol. Venereol. 2021, 35, 150–158. [Google Scholar] [CrossRef] [PubMed]
- Barry, K.; Zancanaro, P.; Casseres, R.; Abdat, R.; Dumont, N.; Rosmarin, D. Concomitant atopic dermatitis and psoriasis—A retrospective review. J. Dermatol. Treat. 2021, 32, 716–720. [Google Scholar] [CrossRef] [PubMed]
- Su, Z.; Zeng, Y.P. Dupilumab-Associated Psoriasis and Psoriasiform Manifestations: A Scoping Review. Dermatology 2023, 239, 646–657. [Google Scholar] [CrossRef] [PubMed]
- Gargiulo, L.; Ibba, L.; Pavia, G.; Avagliano, J.; Cortese, A.; Costanzo, A.; Narcisi, A. Upadacitinib for the treatment of concomitant psoriasis and atopic dermatitis: A case series. J. Dermatol. Treat. 2023, 34, 2183729. [Google Scholar] [CrossRef] [PubMed]
- Shahriari, N.; Strober, B.; Shahriari, M. Upadacitinib for the treatment of psoriasiform and spongiotic dermatitis: A multicenter case series. JAAD Case Rep. 2024, 49, 106–109. [Google Scholar] [CrossRef] [PubMed]
- Kameda, H. JAK inhibitors~overview~. Immunol. Med. 2023, 46, 108–111. [Google Scholar] [CrossRef] [PubMed]
- Posada Posada, M.I.; Alora, M.B.; Lima, X.T.V. Metabolic effects of upadacitinib in patients with psoriasis and atopic dermatitis. Arch. Dermatol. Res. 2024, 316, 143. [Google Scholar] [CrossRef] [PubMed]
- Gerosa, S.; De Felici Del Giudice, M.B.; Macchi, S.; Feliciani, C.; Satolli, F. Overlap of psoriasis and atopic dermatitis in patients with comorbidities: A difficult therapeutic challenge. Ital. J. Dermatol. Venereol. 2024, 159, 586–587. [Google Scholar] [CrossRef] [PubMed]
Patient | Age and Sex | Initial Clinical Suspicion | IgE (U/L) | Smoker | BMI | Comorbidities | Biopsy | Prior Treatments | Time Before PSO-AD Onset (Months) | Body Site Involved |
---|---|---|---|---|---|---|---|---|---|---|
CASE 1 | 51 M | AD | 48 | yes | 22 | None | yes | Cyclosporine Dupilumab | 34 | Hands, buttocks, and upper and lower limbs |
CASE 2 | 23 M | AD | 117 | yes | 23 | Factor VII deficiency | yes | Dupilumab | 10 | Face and upper and lower limbs |
CASE 3 | 50 M | PSO | >1000 | yes | - | Allergic bronchial asthma | no | Cyclosporine | 7 | Back, palms, and soles |
CASE 4 | 62 F | PSO | - | no | 26 | Arterial hypertension Dyslipidemia Hypothyroidism | yes | Acitretin Tildrakizumab Bimekizumab | 2 | Erythrodermic |
CASE 5 | 22 F | AD | - | no | - | None | no | Dupilumab Upadacitinib | 2 | Scalp, face, trunk, and upper and lower limbs |
Patient | Current Therapy | Duration of Follow-Up (Months) | Clinical Score | Baseline | T1 (After 1 Month) | T2 (After 3 Months) | T3 (After 6 Months) |
---|---|---|---|---|---|---|---|
CASE 1 | Risankizumab 150 mg | 11 | PGA | 4 | - | 2 | 1 |
BSA | 30 | - | 6 | 3 | |||
DLQI | 10 | - | 2 | 2 | |||
CASE 2 | Risankizumab 150 mg | 12 | PGA | 3 | 2 | 1 | 0 |
BSA | 15 | 6 | 3 | 0 | |||
DLQI | 10 | 3 | 2 | 0 | |||
CASE 3 | Risankizumab 150 mg | 2 | PGA | 3 | 2 | - | - |
BSA | 8 | 4 | - | - | |||
DLQI | 11 | 8 | - | - | |||
CASE 4 | Abrocitinib 200 mg | 4 | PGA | 4 | 2 | 1 | - |
BSA | 70 | 8 | 3 | - | |||
DLQI | 25 | 5 | 2 | - | |||
CASE 5 | Abrocitinib 200 mg | 8 | PGA | 3 | 3 | 1 | 1 |
BSA | 20 | 10 | 5 | 3 | |||
DLQI | 15 | 15 | 4 | 2 |
Disclaimer/Publisher’s Note: The statements, opinions and data contained in all publications are solely those of the individual author(s) and contributor(s) and not of MDPI and/or the editor(s). MDPI and/or the editor(s) disclaim responsibility for any injury to people or property resulting from any ideas, methods, instructions or products referred to in the content. |
© 2025 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
Share and Cite
de Felici del Giudice, M.B.; Ravaglia, G.; Brusasco, M.; Satolli, F. Managing the Overlap: Therapeutic Approaches in Patients with Concomitant Psoriasis and Atopic Dermatitis—A Case Series. J. Clin. Med. 2025, 14, 796. https://doi.org/10.3390/jcm14030796
de Felici del Giudice MB, Ravaglia G, Brusasco M, Satolli F. Managing the Overlap: Therapeutic Approaches in Patients with Concomitant Psoriasis and Atopic Dermatitis—A Case Series. Journal of Clinical Medicine. 2025; 14(3):796. https://doi.org/10.3390/jcm14030796
Chicago/Turabian Stylede Felici del Giudice, Maria Beatrice, Giorgia Ravaglia, Marco Brusasco, and Francesca Satolli. 2025. "Managing the Overlap: Therapeutic Approaches in Patients with Concomitant Psoriasis and Atopic Dermatitis—A Case Series" Journal of Clinical Medicine 14, no. 3: 796. https://doi.org/10.3390/jcm14030796
APA Stylede Felici del Giudice, M. B., Ravaglia, G., Brusasco, M., & Satolli, F. (2025). Managing the Overlap: Therapeutic Approaches in Patients with Concomitant Psoriasis and Atopic Dermatitis—A Case Series. Journal of Clinical Medicine, 14(3), 796. https://doi.org/10.3390/jcm14030796