Pharma 5: What is Immunodermatology? 5 Common Conditions

Skin is the largest organ of the human body.¹ Being external, it makes sense to think of the skin as our front line of defense from potential pathogens, making it a crucial part of the immune system. As such, immunodermatology sheds light on immune conditions that affect the skin, hair and nails.² Conditions like psoriasis, eczema, vitiligo, lupus and alopecia are some of the most common.

1. Psoriasis

Psoriasis causes a rash with itchy patches. These are most commonly found on the scalp, elbows, trunk of the body and knees. While the cause is still unknown, it is believed that psoriasis appears as a result of the immune system causing skin cells to grow faster than usual. The rapid turnover of cells causes the dry, scaly patches. Psoriasis is not contagious and it’s believed genetics and environment play a role in the condition. People who are predisposed to psoriasis may be symptom-free for years until triggered by an environmental factor. Some of the common triggers are infections such as strep; certain drugs like lithium and antimalarial drugs; cuts or scrapes to the skin; cold weather; and more.³

2. Eczema

Eczema itself isn’t an autoimmune disease, but overactive immune systems can contribute to eczema symptoms. There are several types of eczema, and certain types are more common than others in people with allergies or asthma. Triggers can be hard to pinpoint because they differ from person to person. Sometimes a flare comes from multiple triggers, and there can be a lag in time from trigger exposure to the reaction. Common triggers are certain fabrics and metals, pet dander, insect bites, certain fragrances, changing or extreme weather, stress and more.⁴

3. Vitiligo

Vitiligo is an autoimmune disorder in which patches of skin lose color when melanocytes are attacked and destroyed. While many people with vitiligo begin seeing patches before age 20, it can develop at any time. It appears more commonly in people with a family history of the condition or people who have other autoimmune conditions such as psoriasis, thyroid disease and more. Treatments focus on stopping progression and sometimes reversing effects, evening out skin tone appearance.⁵

4. Lupus

Lupus is an autoimmune disease that primarily affects joints, skin and internal organs such as the kidneys and heart. There are several different types of lupus, but cutaneous lupus is a form limited to the skin and even it has different forms, too.⁶ There isn’t a cure for lupus, but treatment can help control symptoms, keep the immune system functioning properly and protect organs. Both prescription and over-the-counter prescription medications like anticoagulants, anti-inflammatories, immunosuppressives and others can treat lupus.⁷

5. Alopecia Areata

Alopecia is another autoimmune disease leading to hair loss. The hair loss can appear anywhere on the body, face or scalp. The type of hair loss can present differently from small patches of hair loss to significant hair loss in a short amount of time. Additionally, other symptoms such as burning or itching in the hair loss area, hair loss occurring during colder months and more may occur.⁸ Some people with mild alopecia don’t treat the condition and choose to use accessories like scarves and hairpieces or hairstyles to camouflage the hair loss. Corticosteroids, minoxidil and topical immunotherapy can help stimulate hair growth in bald patches. However, about a third of patients with alopecia also have eczema or atopic dermatitis, so dupilumab (Dupixent) is approved by the U.S. Food and Drug Administration for treatment. Finally, Janus-associated kinases (JAK) inhibitors are the first-line treatment for patients with severe alopecia, which can be used in combination with oral minoxidil.⁹

Immunodermatology reminds us that the skin is more than a protective barrier. It is an active part of the immune system, and when that system misfires, the effects can show up in skin, hair and nails. Psoriasis, eczema, vitiligo, lupus and alopecia areata each look and behave differently, but all of them reflect a close link between immune function and skin health. While some of these conditions have no cure, treatment options continue to expand, offering real relief and improved quality of life for many people.