Kaszycki Margaret A, Pixley Jessica N, Feldman Steven R
Center for Dermatology Research, Department of Dermatology, Wake Forest School of Medicine, Winston-Salem, North Carolina.Dr. Feldman also is from the Department of Pathology and the Department of Social Sciences and Health Policy.
Cutis. 2023 Sep;112(3):E13-E16. doi: 10.12788/cutis.0858.
Atopic dermatitis (AD) and psoriasis are chronic inflammatory skin conditions with clinical and histopathologic features that often overlap, representing an underlying immunopathological spectrum of disease that can complicate the proper diagnosis and treatment of both conditions. We report the case of a patient with longstanding concurrent, treatment-resistant AD and psoriasis who was successfully treated with dual biologic therapy with dupilumab and guselkumab. Our case highlights the importance of considering coexisting AD and psoriasis in patients with treatment-resistant disease and the utility of dual biologic therapy. We also review an established but rare incidence of overlap between AD and psoriasis and highlight diagnostic challenges and the importance of assessing patients comprehensively. Our case also demonstrates the utility of patch testing and tissue diagnosis in patients with concurrent AD and psoriasis, as well as the importance of considering both diagnostic testing and clinical response in clinical decision-making.
特应性皮炎(AD)和银屑病是慢性炎症性皮肤病,其临床和组织病理学特征常常重叠,代表了一种潜在的免疫病理学疾病谱,这可能会使这两种疾病的正确诊断和治疗变得复杂。我们报告了一例长期同时患有难治性AD和银屑病的患者,该患者通过度普利尤单抗和古塞库单抗双重生物疗法成功治愈。我们的病例强调了在患有难治性疾病的患者中考虑同时存在AD和银屑病的重要性以及双重生物疗法的效用。我们还回顾了AD和银屑病之间既定但罕见的重叠发生率,并强调了诊断挑战以及全面评估患者的重要性。我们的病例还证明了斑贴试验和组织诊断在同时患有AD和银屑病患者中的效用,以及在临床决策中考虑诊断测试和临床反应的重要性。