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Updated: Oct 13, 2026

Imaging CD4 T Cell Interstitial Migration in the Inflamed Dermis
Published on: March 25, 2016
Immune shifts in inflammatory skin diseases
Hugo Cometto1, Fanny Saidoune1, Jeremy Di Domizio1
1Department of Dermatology, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
Abstract:
Inflammatory skin diseases are driven by dominant immune programs, including T helper (Th)1, Th2, Th17, type I IFN, and neutrophilic pathways, which shape responsiveness to targeted immunotherapies. Molecular profiling has revealed that these diseases frequently harbor additional, coexisting immune programs and that dominance among pathways can shift over time, either spontaneously or in response to therapy. Such immune shifts, which limit therapeutic effectiveness, often occur in the absence of clinically evident morphological changes. In this review, we describe the molecular immune landscape of inflammatory skin diseases, with an emphasis on psoriasis and atopic dermatitis, and illustrate the immune shifts that underlie therapy-resistant disease states and paradoxical reactions. We propose a model of an immune continuum governed by a dynamic equilibrium among inflammatory pathways that is susceptible to displacement. Finally, we highlight molecular immune profiling as a critical tool for detecting such shifts and enabling rational therapeutic adaptation.
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