银屑病-特应性皮炎重叠表型：免疫失衡机制与临床诊治新视角

doi:10.35541/cjd.20250219

中华皮肤科杂志 ›› 2025, Vol. 58 ›› Issue (11): 1009-1014.doi: 10.35541/cjd.20250219

银屑病-特应性皮炎重叠表型：免疫失衡机制与临床诊治新视角

宋志强何远雄陈安祺

陆军军医大学西南医院皮肤科，重庆 400038

收稿日期:2025-04-22 修回日期:2025-09-25 发布日期:2025-11-03
通讯作者: 宋志强 E-mail:drsongzq@tmmu.edu.cn
基金资助:
国家自然科学基金（82273529）

Psoriasis-atopic dermatitis overlap phenotype: immune dysregulation mechanisms and emerging clinical insights

Song Zhiqiang, He Yuanxiong, Chen Anqi

Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing 400038, China

Received:2025-04-22 Revised:2025-09-25 Published:2025-11-03
Contact: Song Zhiqiang E-mail:drsongzq@tmmu.edu.cn
Supported by:
National Natural Science Foundation of China（82273529）

摘要/Abstract

摘要： 【摘要】特应性皮炎与银屑病是两种免疫机制截然不同的慢性炎症性皮肤病，分别由辅助性T细胞2（Th2）型炎症和Th1/Th17通路主导。然而，临床实践中发现部分患者可同时或序贯出现银屑病-特应性皮炎重叠表型（PAO），表现为鳞屑性红斑与湿疹样皮损共存。目前，PAO的命名、诊断标准及发病机制尚未明确，且随着靶向治疗的广泛应用，其发生率呈上升趋势。PAO的诊断需综合临床特征、组织病理学表现及生物标志物评估，而治疗则需平衡免疫调节与个体化策略。本文结合临床实践，系统总结PAO的特征性表现及其遗传与免疫交互机制，并探讨诊断挑战与治疗选择，以应对这一复杂且日益凸显的临床问题。

关键词: 皮炎, 特应性, 银屑病, 湿疹, 重叠, 免疫机制, 分子靶向治疗

Abstract: 【Abstract】 Atopic dermatitis and psoriasis are two chronic inflammatory skin diseases with distinct immune mechanisms, primarily driven by Th2-type inflammation and Th1/Th17 pathways, respectively. However, some patients may simultaneously or sequentially exhibit overlapping phenotypes of atopic dermatitis and psoriasis（psoriasis-atopic dermatitis overlap, PAO）, characterized by the coexistence of scaly erythema and eczematous lesions. Currently, the nomenclature, diagnostic criteria, and pathogenesis of PAO remain unclear, and its incidence is increasing due to the widespread use of targeted therapies. The diagnosis of PAO requires an integrated assessment of clinical features, histopathological findings, and biomarker profiles, while treatment necessitates a balance between immune modulation and individualized strategies. This article summarizes the characteristic manifestations of and genetic-immune interactions involved in PAO based on clinical practice, and explores diagnostic challenges and therapeutic options to address this complex and increasingly prominent clinical issue.

Key words: Dermatitis, atopic, Psoriasis, Eczema, Overlap, Immune mechanism, Molecular targeted therapy

宋志强何远雄陈安祺. 银屑病-特应性皮炎重叠表型：免疫失衡机制与临床诊治新视角[J]. 中华皮肤科杂志, 2025,58(11):1009-1014. doi:10.35541/cjd.20250219

Song Zhiqiang, He Yuanxiong, Chen Anqi. Psoriasis-atopic dermatitis overlap phenotype: immune dysregulation mechanisms and emerging clinical insights[J]. Chinese Journal of Dermatology, 2025, 58(11): 1009-1014.doi:10.35541/cjd.20250219

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银屑病-特应性皮炎重叠表型：免疫失衡机制与临床诊治新视角

Psoriasis-atopic dermatitis overlap phenotype: immune dysregulation mechanisms and emerging clinical insights

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