Differentiating psoriasis from eczema poses high demands on diagnostic abilities and still is error prone. The regulation of the genes NOS2 and CCL27 showed the most discriminatory power between both diseases and was used to train a highly accurate algorithm that can enhance conventional ways of diagnosis. The Molecular Classifier (MC) is used since 12/2021 in an occupational dermatological cohort that is later compared to an already existing cohort without MC use. The aim is to investigate if the diagnosis via molecular analysis influences course of the skin disease, therapeutic measures and quality of life. In a baseline and 4 follow-ups data will be collected from dermatologists and patients. To date, 211 patients are included (nmale=113, μAge= 49.7). In median, the skin disease has been persisting for 4 years and affects mosty the palms (68%), interspaces (41%) and backs (30%) of the hands, also feet (49%) and legs (25%). Most of the patients have chronical (70%) or chronically relapsing (24%) disease courses. 36.5% of the patients had clinically unclear diagnoses at study inclusion. In all but three of these cases, the MC shows a clear tendency towards one disease. The case-specific congruence is low (34%). 29.6% of these matches allot to eczemas. When linking the 95 available histological results to these findings, the complete congruence reduces to 16.3%. The highest match is again for eczema. 6 months after the use of the MC the amount of systemic therapies increases (alitretinoin: +16.3%, acitretin +5.1%, dupilumab +7.1%). The absolute amount of topical therapies is constant. The use of glucocorticosteroids is clearly reduced (-13.3%). A significant (p<0.0001) increase in Dermatology Life Quality Index can be seen. The high amount of unclear cases underlines the diagnostic challenges in the differentiation of psoriasis and eczema. The MC shows high potential in complementing existing diagnostics and leading to improved patient outcomes even in long persisting cases.

ESDR111 - Overcoming diagnostic challenges in differentiation of psoriasis and eczema with molecular analysis.

The scientific meeting of the European Society for Dermatological Research (ESDR) is held yearly, usually in September. With an international attendance of more than 1000 skin scientists from around the globe, the four-day event includes short oral presentations from peer-reviewed abstracts, keynote lectures from international experts, sponsored symposia, satellite programs, educational events as well as an important focus on posters, networking and building collaborations amongst scientists. For more information about this year’s meeting visit our website.