Brănișteanu Daciana Elena, Boțoc Cristina Colac, Huțanu Antonia Elena, Munteanu Cătălina Anca, Ciobanu Roxana Paraschiva, Brănișteanu Daniel Constantin, Colac Alin Gabriel, Onu-Brănișteanu Cătălina Ioana, Brănișteanu George, Manolache Nicuta, Porumb-Andrese Elena, Toader Mihaela-Paula
Discipline of Dermatology, 'Grigore T. Popa' University of Medicine and Pharmacy, 16 Universitatii Str., 700115 Iasi, Romania.
Dermatology Clinic, University Clinical Railways Hospital, 1 Garabet Ibraileanu Str., 700115 Iasi, Romania.
Diagnostics (Basel). 2025 May 29;15(11):1381. doi: 10.3390/diagnostics15111381.
Psoriasis and atopic dermatitis (AD) are immune-mediated inflammatory diseases traditionally viewed as distinct. However, a subset of patients may present with overlapping features, leading to diagnostic and therapeutic challenges. This study aims to characterize the clinical, histopathological, and therapeutic features of patients with psoriasis-AD overlap. A retrospective review was conducted on patients diagnosed with both psoriasis vulgaris and AD between January 2021 and October 2024 at a single tertiary dermatology center. Inclusion required histopathological confirmation of psoriasis and a clinical diagnosis of AD based on Hanifin and Rajka criteria. Clinical features, histopathology, treatment history, and 6-month outcomes were analyzed. Out of 469 patients screened, 24 (5.1%) had both conditions. Psoriasis preceded AD in 91.6% of cases. Most patients had intrinsic AD subtypes and moderate-to-severe diseases. Palmoplantar involvement was present in 66.6%, often refractory to biologics alone. Histological overlap complicated diagnosis, with repeated biopsies required in 58.3% of cases. Patients with dual diseases often required combination therapy, and JAK inhibitors showed favorable outcomes in refractory cases. Psoriasis-AD overlap represents a distinct clinical entity requiring individualized diagnosis and management. Recognition of this phenotype is critical for optimizing therapeutic outcomes.
银屑病和特应性皮炎（AD）是传统上被视为不同的免疫介导的炎症性疾病。然而，一部分患者可能表现出重叠特征，导致诊断和治疗方面的挑战。本研究旨在描述银屑病-AD重叠患者的临床、组织病理学和治疗特征。对2021年1月至2024年10月期间在一家单一的三级皮肤科中心被诊断为寻常型银屑病和AD的患者进行了回顾性研究。纳入标准要求有银屑病的组织病理学确诊以及基于哈尼芬和拉伊卡标准的AD临床诊断。分析了临床特征、组织病理学、治疗史和6个月的结局。在469名筛查患者中，24名（5.1%）患有这两种疾病。在91.6%的病例中，银屑病先于AD出现。大多数患者为内在型AD亚型且患有中度至重度疾病。66.6%的患者有掌跖受累，通常对单独使用生物制剂难治。组织学重叠使诊断复杂化，58.3%的病例需要重复活检。患有双重疾病的患者通常需要联合治疗，JAK抑制剂在难治性病例中显示出良好的疗效。银屑病-AD重叠代表一种独特的临床实体，需要个体化的诊断和管理。认识到这种表型对于优化治疗结局至关重要。
