Abrocitinib Treatment of Atopic Dermatitis or Eczema in Patients with Coexistent or Prior Psoriasis: Three Cases with Literature Review

Purpose: To characterize clinical outcomes of abrocitinib in patients with coexistent psoriasis and atopic dermatitis (AD)/eczema and to synthesize published case-level evidence on Janus kinase (JAK) inhibitors and other biologic strategies for this overlap phenotype. Patients and Methods: We retrospectively reviewed three adults with psoriasis and concurrent eczema/AD-like dermatitis treated with abrocitinib, with outcomes assessed using PASI, SCORAD/IGA, and PP-NRS. A structured search of MEDLINE, Embase, and Web of Science (inception to 31 December 2025) identified eligible reports describing clinically diagnosed psoriasis–eczema/AD overlap treated with JAK inhibitors or biologic agents, with independent screening and de-duplication. Results: Two patients receiving abrocitinib 100 mg/day achieved marked improvement, and one patient refractory to upadacitinib 30 mg/day improved after switching to abrocitinib 200 mg/day; no treatment-related adverse events were observed, and one patient had no recurrence during > 4 months of follow-up. In the literature synthesis, 16 JAK inhibitor–treated cases (abrocitinib, upadacitinib, baricitinib) showed consistent clinical benefit, with PASI decreasing from 9– 25.9 to 0– 3.2 and SCORAD/EASI decreasing from 24.6– 71.1 to 0– 30.4, and no adverse events reported. Nine cases treated with other biologics also improved (PASI 9.1– 35 to 3– 7.2; SCORAD/EASI 19.4– 59 to 0– 9.4), with conjunctivitis reported in one dual-biologic case. Conclusion: Systemic JAK inhibition may offer an integrated option for psoriasis with coexisting eczema/AD, enabling concurrent lesion and symptom control with favorable short-term tolerability. Larger prospective studies with standardized diagnostic confirmation and harmonized outcome reporting are required to clarify long-term safety, durability, and optimal positioning versus biologic regimens.