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Causal associations between psoriasis and atopic dermatitis: A bidirectional Mendelian randomization study.

Zixia Wang1,2, Hao Nie2, Xinyu Fan2

  • 1Dongguan TCM Hospital of Guangzhou University of Chinese Medicine, Dongguan, China.

Plos One
|September 8, 2025
PubMed
Summary

Psoriasis genetically protects against atopic dermatitis (AD), reducing AD risk. However, atopic dermatitis (AD) does not influence psoriasis risk, indicating a one-way causal relationship between these inflammatory skin conditions.

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Area of Science:

  • Dermatology
  • Genetics
  • Epidemiology

Background:

  • The relationship between psoriasis and atopic dermatitis (AD) is complex and debated.
  • Previous research suggests an association, but causality and directionality are unclear.

Purpose of the Study:

  • To investigate the causal relationship between psoriasis and atopic dermatitis (AD) using a bidirectional Mendelian randomization approach.
  • To determine if psoriasis influences AD risk or vice versa.

Main Methods:

  • Utilized genome-wide association statistics for psoriasis and AD from large consortia.
  • Employed inverse-variance weighting as the primary analysis, supplemented by sensitivity analyses to assess robustness and pleiotropy.
  • Performed gene mapping and pathway analysis for psoriasis-associated single-nucleotide polymorphisms.

Main Results:

  • Genetic predisposition to psoriasis significantly decreased the risk of developing AD (OR=0.876, P=1.6×10-7).
  • Genetic predisposition to AD did not impact psoriasis risk.
  • Consistent results across sensitivity analyses with no evidence of horizontal pleiotropy.
  • Identified key genes including NOS2, involved in TCR signaling and protein metabolism.

Conclusions:

  • Psoriasis exerts a protective causal effect on the risk of AD.
  • No reverse causal relationship from AD to psoriasis was observed.
  • Findings clarify the etiological relationship between psoriasis and AD, with potential clinical management implications.