Clinical Report: Psoriasis–AD Switching May Mimic Treatment Failure
Overview
A retrospective cohort study identified persistent phenotype switching between psoriasis and atopic dermatitis during systemic or biologic therapy. The study involved 148 patients across multiple countries and highlighted the need for recognition of this phenomenon.
Background
Understanding the relationship between psoriasis and atopic dermatitis is crucial for effective management, as treatment-associated phenotype switching can complicate clinical decision-making. This study describes how systemic therapies can lead to unexpected changes in disease presentation.
Data Highlights
| Switch Type | Percentage of Cases | Mean Treatment Duration (months) |
|---|---|---|
| Psoriasis to Eczematous | 58% | 17 |
| Atopic Dermatitis to Psoriasiform | 91.5% | 18 |
Key Findings
- 101 patients developed eczematous features while on psoriasis treatment.
- 47 patients developed psoriasiform disease while on atopic dermatitis treatment.
- Interleukin-17 inhibitors were most associated with psoriasis-to-eczematous switching.
- Dupilumab was linked to 91.5% of atopic dermatitis-to-psoriasiform switches.
- Janus kinase inhibitors were the most common management strategy following phenotype switching.
- Clinical severity scores improved significantly after treatment modification in both groups.
Clinical Implications
Physicians should consider the possibility of sustained phenotype switching when patients exhibit opposing features during targeted therapy.
Conclusion
The study highlights the importance of recognizing treatment-associated phenotype switching in psoriasis and atopic dermatitis.
Related Resources & Content
- MDSpire News, 2026 -- Does Changing Biologics Clear Skin Faster?
- Frontiers in Medicine, 2026 -- Effectiveness and safety of switching biologics after secukinumab treatment failure in moderate-to-severe plaque psoriasis: a retrospective cohort study
- Clinical Rheumatology, 2021 -- Factors Influencing Treatment Switches in Psoriatic Arthritis Patients Receiving Anti-TNFα, Anti-IL12/23, or Anti-IL17 Therapies: Findings from a 15-Year Monocentric Study
- Frontiers in Immunology, 2026 -- Divergent immunometabolic reprogramming in psoriasis and atopic dermatitis: a tale of two inflammatory skin diseases
- Treatment-associated phenotype switching between psoriasis and atopic dermatitis - PubMed, 2026
- Predictive factors for eczematous eruptions and candidiasis during anti-interleukin-17 treatment in patients with psoriasis: a multicentre real-life experience in Lazio region, Italy | Clinical and Experimental Dermatology
- Atopic dermatitis clinical guideline, 2025
- Multicenter, multinational retrospective cohort study on psoriasis and AD
- Real-world data on dupilumab and psoriasis risk
- Atopic dermatitis clinical guideline
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