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Updated: Sep 21, 2025
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The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
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Concurrent Atopic Dermatitis and Psoriasis Vulgaris: Implications for Targeted Biologic Therapy
Matthew C Johnson1, Nathan L Bowers1, Lindsay C Strowd1
1Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.
Cutis
|June 6, 2022
Summary
Biologic medications targeting specific immune pathways can paradoxically alter inflammatory skin conditions. A patient treated for psoriasis then developed atopic dermatitis, and later, psoriasis re-emerged after atopic dermatitis treatment.
Area of Science:
- Immunodermatology
- Translational immunology
- Cutaneous inflammation
Background:
- Psoriasis vulgaris is a T helper 1 (TH1)/TH17-mediated dermatosis responsive to IL-17A inhibitors like secukinumab.
- Atopic dermatitis (AD) is a T helper 2 (TH2)-mediated condition often treated with IL-4/IL-13 inhibitors such as dupilumab.
Observation:
- A patient with psoriasis controlled by secukinumab developed severe AD.
- This patient's AD improved with dupilumab treatment.
Findings:
- Following dupilumab therapy for AD, the patient experienced a recurrence of psoriasis.
- This suggests a potential phenotypic switch between TH1/TH17 and TH2 mediated inflammatory skin diseases.
Implications:
- Targeting specific immune axes (e.g., TH1/TH2) with biologics may lead to unintended consequences and disease flares.
- Understanding these complex immune interactions is crucial for managing chronic inflammatory skin conditions.
- Further research is needed to elucidate the mechanisms underlying treatment-induced phenotypic switching in dermatoses.
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