Chinese Journal of Dermatology ›› 2025, Vol. 58 ›› Issue (11): 1009-1014.doi: 10.35541/cjd.20250219

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

Song Zhiqiang, He Yuanxiong, Chen Anqi   

  1. Department of Dermatology, Southwest Hospital, Army Medical University, Chongqing 400038, China
  • Received:2025-04-22 Revised:2025-09-25 Online:2025-11-15 Published:2025-11-03
  • Contact: Song Zhiqiang E-mail:drsongzq@tmmu.edu.cn
  • Supported by:
    National Natural Science Foundation of China(82273529)

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