{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T11:03:00Z","timestamp":1791975780035,"version":"4.4.0"},"reference-count":15,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2025,1,25]],"date-time":"2025-01-25T00:00:00Z","timestamp":1737763200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Introduction: Psoriasis (PSO) and atopic dermatitis (AD) have traditionally been considered distinct diseases, respectively, mediated by T-helper 1 (Th1) and the T-helper 2 (Th2) immune pathway. In recent years, there has been a growing body of evidence highlighting an overlap between the two conditions, such as Asian AD, pediatric PSO, or \u201cpsoriasis dermatitis\/PSOREMA\u201d. Moreover, psoriasis dermatitis can be induced by therapeutic interventions. For instance, anti-IL-4\/IL-13 monoclonal antibodies, commonly used to treat AD, can induce psoriasiform reactions by inhibiting the Th2 pathway, thereby unmasking Th1\/Th17-driven PSO. Conversely, anti-TNF\u03b1 and anti-IL-17 therapies, effective for PSO, may induce eczematous reactions promoting a switch toward Th2-driven inflammation. Janus Kinase Inhibitors (JAK-i) and IL-23 antagonists may represent valid therapeutic options for managing psoriasis dermatitis. JAK-i exert broader immunomodulatory effects, inhibiting both Th1 and Th2 pathways; however, they require careful monitoring due to potential adverse events. In contrast, IL-23 antagonists specifically suppress the IL-23\/IL-17 axis inhibiting the p19 subunit of IL-23 and could represent a safer option for patients with psoriasis dermatitis. Materials and Methods\/Results: We present a series of five cases of psoriasis dermatitis, including both patients who had the condition from the onset and those who developed it during treatment, with tailored therapeutic strategies based on individual patient profiles, comorbidities, and the specific characteristics of their overlapping disease presentation. Conclusion: JAK-i and IL-23 antagonists are both valid therapeutic options for managing psoriasis dermatitis, but with different immunomodulatory effects and safety profiles. Future research should focus on a better understanding of the immune pathway and identifying specific biomarkers of psoriasis dermatitis, to optimize therapeutic strategies.<\/jats:p>","DOI":"10.3390\/jcm14030796","type":"journal-article","created":{"date-parts":[[2025,1,28]],"date-time":"2025-01-28T07:54:08Z","timestamp":1738050848000},"page":"796","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Managing the Overlap: Therapeutic Approaches in Patients with Concomitant Psoriasis and Atopic Dermatitis\u2014A Case Series"],"prefix":"10.3390","volume":"14","author":[{"given":"Maria Beatrice","family":"de Felici del Giudice","sequence":"first","affiliation":[{"name":"Dermatology Unit, Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-4490-6458","authenticated-orcid":false,"given":"Giorgia","family":"Ravaglia","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1176-7197","authenticated-orcid":false,"given":"Marco","family":"Brusasco","sequence":"additional","affiliation":[{"name":"Dermatology Unit, ASST Santi Paolo e Carlo, I-20142, Milan, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Francesca","family":"Satolli","sequence":"additional","affiliation":[{"name":"Dermatology Unit, Department of Medicine and Surgery, University of Parma, I-43121 Parma, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,25]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Tsai, Y.C., and Tsai, T.F. (2022). Overlapping Features of Psoriasis and Atopic Dermatitis: From Genetics to Immunopathogenesis to Phenotypes. Int. J. Mol. Sci., 23.","DOI":"10.3390\/ijms23105518"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"68","DOI":"10.1016\/j.coi.2017.08.008","article-title":"Atopic dermatitis and psoriasis: Two different immune diseases or one spectrum?","volume":"48","author":"Krueger","year":"2017","journal-title":"Curr. Opin. Immunol."},{"key":"ref_3","first-page":"166","article-title":"Psoriasis dermatitis: A new entity or a different phenotypic expression of psoriasis and atopic dermatitis?","volume":"159","author":"Bardazzi","year":"2024","journal-title":"Ital. J. Dermatol. Venerol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"e29","DOI":"10.1002\/ski2.29","article-title":"Can atopic eczema and psoriasis coexist? A systematic review and meta-analysis","volume":"1","author":"Cunliffe","year":"2021","journal-title":"Skin. Health Dis."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"43","DOI":"10.1016\/j.jid.2023.06.194","article-title":"Genomic Profiling of the Overlap Phenotype Between Psoriasis and Atopic Dermatitis","volume":"144","author":"Kim","year":"2024","journal-title":"J. Investig. Dermatol."},{"key":"ref_6","doi-asserted-by":"crossref","unstructured":"Trave, I., Salvi, I., Burlando, M., Cozzani, E., and Parodi, A. (2023). \u201cDe Novo\u201d Psoriasis and Relapse of Psoriasis Induced by Dupilumab: Three New Cases and Review of the Literature. J. Clin. Med., 12.","DOI":"10.3390\/jcm12196291"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jaci.2018.10.032","article-title":"Atopic dermatitis endotypes and implications for targeted therapeutics","volume":"143","author":"Czarnowicki","year":"2019","journal-title":"J. Allergy Clin. Immunol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/jdv.16563","article-title":"Identification of a TH 2-high psoriasis cluster based on skin biomarker analysis in a Chinese psoriasis population","volume":"35","author":"Chen","year":"2021","journal-title":"J. Eur. Acad. Dermatol. Venereol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"716","DOI":"10.1080\/09546634.2019.1702147","article-title":"Concomitant atopic dermatitis and psoriasis\u2014A retrospective review","volume":"32","author":"Barry","year":"2021","journal-title":"J. Dermatol. Treat."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"646","DOI":"10.1159\/000530608","article-title":"Dupilumab-Associated Psoriasis and Psoriasiform Manifestations: A Scoping Review","volume":"239","author":"Su","year":"2023","journal-title":"Dermatology"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"2183729","DOI":"10.1080\/09546634.2023.2183729","article-title":"Upadacitinib for the treatment of concomitant psoriasis and atopic dermatitis: A case series","volume":"34","author":"Gargiulo","year":"2023","journal-title":"J. Dermatol. Treat."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"106","DOI":"10.1016\/j.jdcr.2024.05.009","article-title":"Upadacitinib for the treatment of psoriasiform and spongiotic dermatitis: A multicenter case series","volume":"49","author":"Shahriari","year":"2024","journal-title":"JAAD Case Rep."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"108","DOI":"10.1080\/25785826.2023.2183594","article-title":"JAK inhibitors~overview~","volume":"46","author":"Kameda","year":"2023","journal-title":"Immunol. Med."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s00403-024-02892-7","article-title":"Metabolic effects of upadacitinib in patients with psoriasis and atopic dermatitis","volume":"316","author":"Alora","year":"2024","journal-title":"Arch. Dermatol. Res."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"586","DOI":"10.23736\/S2784-8671.24.07937-4","article-title":"Overlap of psoriasis and atopic dermatitis in patients with comorbidities: A difficult therapeutic challenge","volume":"159","author":"Gerosa","year":"2024","journal-title":"Ital. J. Dermatol. Venereol."}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/796\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:36:17Z","timestamp":1759919777000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/14\/3\/796"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,25]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["jcm14030796"],"URL":"https:\/\/doi.org\/10.3390\/jcm14030796","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,25]]}}}