Psoriasis and Atopic Dermatitis Overlap: Pathogenesis and Therapeutic Considerations for the Clinician

Psoriasis (PsO) and atopic dermatitis (AD) are chronic, inflammatory skin diseases with distinct, yet occasionally overlapping, immunological profiles. PsO is characterized by T helper (Th) 1/Th17 immune pathways, while AD predominantly involves Th2 responses. However, a subset of patients exhibit features of both conditions, presenting a diagnostic and therapeutic challenge. This review aims to comprehensively assess the pathogenesis, clinical presentation, and therapeutic considerations of the PsO–AD overlap phenotype. This unique clinical entity is characterized by mixed Th17/Th2 immune responses, including elevated levels of interleukin (IL)-17A, IL-23, IL-4, and IL-13, complicating diagnosis and treatment strategies. Recent insights into the genetic, immunological, and environmental contributors to this phenotype, alongside emerging biomarker-guided therapies, offer potential for more precise management.