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Updated: May 16, 2026

Lymphocyte Isolation from Human Skin for Phenotypic Analysis and Ex Vivo Cell Culture
10:31

Lymphocyte Isolation from Human Skin for Phenotypic Analysis and Ex Vivo Cell Culture

Published on: April 8, 2016

Treatment-associated phenotype switching between psoriasis and atopic dermatitis

Tiago Torres1,2, Mario Valenti3,4, Anna Balato5

  • 1Department of Dermatology, Centro Académico Clínico ICBAS/Santo António, Porto, Portugal.

Journal of the European Academy of Dermatology and Venereology : JEADV
|May 14, 2026
PubMed

Insights

Psoriasis and atopic dermatitis (AD) phenotype switching is a real-world phenomenon. Janus kinase (JAK) inhibitors effectively manage these treatment-associated immune changes, improving patient outcomes.

Area of Science:

  • Dermatology and immunology
  • Inflammatory skin diseases
  • Therapeutic outcomes

Background:

  • Psoriasis and atopic dermatitis (AD) are distinct inflammatory skin conditions.
  • Targeted therapies reveal a 'flip-flop' phenomenon: eczematous changes in psoriasis patients or psoriasiform disease in AD patients.
  • Limited real-world data exists on this treatment-associated phenotype switch.

Purpose of the Study:

  • Characterize treatment-associated phenotype switching between psoriasis and AD.
  • Analyze clinical features, therapies, management, and outcomes in a large real-world cohort.

Main Methods:

  • Retrospective, multicentre, multinational observational study.
  • Included patients with psoriasis or AD experiencing a persistent phenotype switch linked to systemic or biologic therapy.
  • Collected and analyzed demographic, clinical, therapeutic, and outcome data.

Main Results:

  • 148 patients included: 101 (PsO→eczematous) and 47 (AD→psoriasiform).
  • PsO→eczematous switches linked to IL-17/IL-23 inhibitors; AD→psoriasiform switches linked to type 2 biologics (e.g., dupilumab).
  • Janus kinase (JAK) inhibitors were the most common management strategy for both switch types, leading to marked clinical improvement.

Conclusions:

  • Treatment-associated phenotype switching is a reproducible, bidirectional phenomenon reflecting immune plasticity.
  • Recognizing this switch is crucial for appropriate therapeutic adaptation.
  • JAK inhibitors show promise as an effective management option for these switches.
Keywords:
JAK inhibitorsTNF inhibitorsatopic dermatitisbiologic agentsdupilumabinterleukin‐17 inhibitorsinterleukin‐23 inhibitorsphenotype switchingpsoriasisreal‐world evidenceupadacitinib

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