Search This Blog

Thursday, June 2, 2011

Psoriasis and atopic dermatitis: The same, only different

In the May issue of JACI, Guttman-Yassky et al. (J Allergy Clin Immunol 2011;127:1110-1118), in part 1 of a 2-part review, covered the clinical and pathological similarities and differences between psoriasis and atopic dermatitis (AD) with AD as the point of reference. They finish up in this month’s issue (J Allergy Clin Immunol 2011;127:1420-1432) with a broad discussion comparing the immune phenotypes and therapies for AD and psoriasis.

In part 1, Guttman-Yassky et al. pointed out that psoriasis and AD both present with defects in skin barrier function, skin lesions infiltrated by increased numbers of T cells and dendritic cells and upregulation of epidermal proliferation genes. They note that the chronic phase of AD is more similar to psoriasis than the acute phase. There are distinct differences though. AD patients are susceptible to bacterial and viral skin infections, which is not true for psoriasis patients. Also, AD skin is characterized by decreases in keratinocyte differentiation, cornification, moisture and lipid content. Though lipid depletion is also observed for psoriasis, it is characterized by increased differentiation and cornification. Cytokine milieu in AD is dominated by TH2 cells, while psoriasis is associated with TH1 and TH17 cytokines. Additionally, AD is associated with structural protein anomalies (e.g., filaggrin dysfunction) that are not observed in psoriasis.

The authors discuss in part 2 how the disorders were thought to be mediated by polarized T helper cell responses with TH2 dominance seen in AD; however, this simple dichotomy did not account for all observations, such as hyperkeratinization, seen in chronic AD. They point out that the discovery that TH17 and T22 cells affected epidermal activation eventually led to a new working model wherein psoriasis is mediated by TH1 and TH17 immunity, and AD is mediated by TH2 and T22 cell effects. Production of anti-microbial peptides (AMP) is known to be compromised in AD compared to psoriasis. This was originally attributed to the TH2 environment, but the authors comment that IL-17 deficiency as well as excessive TH2 cytokines can explain the decreased AMP production found in AD. Guttman-Yassky et al note that the impaired AMP production would explain increased susceptibility to skin infections in AD. In contrast, psoriasis is characterized by increased AMP production. The authors also discuss basic differences between AD and psoriasis with regard to differences in dendritic cell populations, AD-associated eosinophilia, barrier defects and inflammation, and mast cell production of interferon gamma (IFN-γ) in psoriasis.

Guttman-Yassky et al. finish up part II with a discussion of the prognosis and intervention for psoriasis and AD. Unlike AD, they note that active psoriasis can be completely resolved and treatment time is short. The authors comment that, in spite of their differences, both AD and psoriasis share epidermal hyperplasia, aberrant immunity, and skin barrier anomalies. This would suggest that immune-based strategies to correct barrier defects that have been developed for psoriasis might be effective for AD. Guttman-Yassky et al. detail current AD treatments and make a case for psoriasis therapies as intervention for AD.

Tell us what you think. Please feel free to post your own comments and/or predictions below.


  1. I don't know, there is much different option to try to heal your symptoms of psoriasis, but from your text I'm under impressions P it's not so dangerous disease, I'm not saying it's dangerous but it's quite ugly and something now one would have to have.

  2. Personally I think that all these skin disorders are sun related..... exacerbated by some other skin irratant. When a person is diagnosed with psoriasis...this is such a broad term. I believe any person can develope psoriasis if exposed to the right catalysts....I also believe that many people develope actinic dermatitis in concert with other skin irratants(atopic dermatitis) and are just lumped into the "psoriasis" heap. From my personal experience "psoriasis" is a normal natural response to "something"

  3. Fighting psoriasis can be a lifelong battle to find the right cure for psoriasis for you and one of the ways to fight psoriasis is to make important lifestyle changes as well as use home remedies for psoriasis. It is important to not lose hope in the fight against psoriasis which can happen after trying various approaches that may have worked for someone else but fail to work for you. You just need to keep experimenting until you find the right psoriasis treatment that works for you.

    Chasteberry Plus

  4. Hello,

    I appreciate your idea here. Th17 lineage is a recently described subset of memory T cells that is characterized by its CD4+ status and its ability to make a constellation of cytokines including interleukin-17A, IL-17F, IL-22, and in humans, IL-26. Definitely it has a good content. Thank you for imparting more of your own thoughts...

  5. This is very educational content and written well for a change. It's nice to see that some people still understand how to write a quality post!
    How to get rid of psoriasis

  6. hello i want to used this opportunity to thank a great doctor oguba who helped me to cured my psoriasis i was directed by sister who received healing from him also. i almost lose hope in life when my sister told me about this great doctor who has healed many people cure psoriasis and cure herpes virus , i thought it will require many things but by the special grace of God every thing was simple, now i am healed from psoriasis, i am now a normal human with out sickness. please my brothers and sisters if there is any one have same problem please remember to contact him now via email:

  7. I have something important to share, for over 4 years now of my marriage i have been trying to get pregnant, this almost made my husband to divorce me because my mother in-law was planning to get him another girl, i was always crying everyday because my marital life way going down. My mother in-law made my husband believe that i was the cause of us being able to give birth, i was always crying, my heart was broken into pieces. My husband and I have been seeing a fertility specialist. We have done one IUI with no luck. My husband has a sperm count which goes up and down, the doctor has recommended him taking the Preseed supplement which he is doing over 3 years with no change in the situation my husband who has low sperm count? It just seems to me that if the sperm are unable to fertilize the egg it will not matter how many are produced. I am was so confused until i contacted this powerful spiritual coven online who I saw a number of testimonies of how he has help so many of them so I sent Mallam Abudu coven a mail and I told them all my sorrows and pain they replied me and ask me not to cry any more that they will help, the sent me some instructions and caution, Mallam Abudu performed the ritual rights and send me a spiritual medicine, they told me to have sex with my husband within 2weeks of doing this I felt dizzy and I went to the doctor and it was confirm that I was pregnant thanks to Mallam Abudu spiritual waters powers now am a mother of a bouncing baby boy and joy has been restored to my marital life and am very happy, no more stress from my mother in-law. If any one needs such help don’t wait all life time to get help in getting pregnant contact Mallam Abudu now on his personal email : Or whatsapp them on +2349055637784

  8. my health restore
    i am so happy to share this testimony with the world because generally there are so many doubts about the cure of hpv and cancer This is real take it serious, i am so happy that today i can give this testimony to the world and also help in savinglife of people who has been condemned for death just as i was ,who will believe that a herbs can cure hpv and cancer completely from thebody, i never believe that this will work, i have spend a lot of money getting drugs from the hospital to keep me healthy, it got to a time that all i was waiting for is death to come because i was broke and i already have strong outbreaks from the hpv, one day i was going through the internet asking questions online just to know more about the latest development in the medical sector to see if there is still hope then i stumbled on a post about about this great man called Dr. Ehiagwina through a publicly made a testimony on how she was also cured of ALS by this herbal doctor who is well known for his strong ancient herbal practice at first i doubted both the woman and the doctor just as so many that see's this post would doubt because medically it has been proven impossible but later i decided to give him a try so i emailed him I did not believe him that much, I just wanted to give him a try, he replied my mail and Needed some Information about me, then I sent them to him, he prepared a herbal medicine and sent it through Courier Service for delivery, he gave my details to the Courier Office. they told me that 3-5 days I will receive the package and after receiving it, i took the medicine as prescribed by him at the end of 13days that the medicine lasted, he told me to go to the hospital for a test, and i went, surprisingly after the test the doctor confirm me hpv negative and cancer disappear i thought it was a joke, i went to other hospitals and was also negative the doctors were speechless and i said it was a miracle, thank you sir for saving my life even if you cannot see this post i shall never stop testifying the impact you made in my life by restoring back my life when i was being stigmatized and even avoided by family and friends , I promise I will always testify of your good works. Dr. Ehiagwina contact: OR call +2348162084504 you can also add him on whatsapp.