Objective:
To describe persistent, treatment-associated phenotype switching between psoriasis and atopic dermatitis and its implications.
Approach:
- Study Design: A multinational retrospective cohort study involving 148 patients treated at 17 dermatology centers across multiple countries.
- Patient Criteria: Patients had psoriasis or atopic dermatitis and developed a persistent switch to the opposing phenotype during systemic or biologic therapy.
- Treatment Analysis: The study analyzed treatment modifications and clinical outcomes following recognition of phenotype switching.
Key Findings:
- 101 patients developed eczematous features while receiving treatment for psoriasis, primarily during interleukin-17 inhibitor therapy.
- 47 patients developed psoriasiform disease while receiving treatment for atopic dermatitis, with dupilumab accounting for 91.5% of these cases.
- Switching from psoriasis to eczematous features was most common during interleukin-17 inhibitor treatment (58%).
- Janus kinase inhibitors were the most frequently documented management strategy post-switch.
Interpretation:
The phenomenon of phenotype switching may be misinterpreted as treatment failure; recognizing it can guide appropriate therapeutic adjustments.
Limitations:
- Retrospective observational design limits causal inference.
- Lack of a comparator population and potential selection bias.
- Incomplete data capture and 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:
This content is an AI-generated, fully rewritten summary based on a published scholarly article. It does not reproduce the original text and is not a substitute for the original publication. Readers are encouraged to consult the source for full context, data, and methodology.
