Optimizing Single T-Cell Transcriptomic Discrimination of Atopic Dermatitis Versus Psoriasis Vulgaris.

Traditionally, inflammatory skin disease has been classified based on clinical and histopathologic features. However, an estimated 3-10% of chronic papulosquamous rashes show clinicopathologic overlap and are challenging to distinguish, especially in the range between psoriasis vulgaris (PV) and atopic dermatitis (AD) ( Chau et al., 2017 Chau T. Parsi K.K. Ogawa T. Kiuru M. Konia T. Li C.-S. et al. Psoriasis or not? Review of 51 clinically confirmed cases reveals an expanded histopathologic spectrum of psoriasis. J Cutan Pathol. 2017; 44: 1018-1026 Crossref PubMed Scopus (29) Google Scholar ; Kouwenhoven et al., 2019 Kouwenhoven T.a. Bronckers I.m. g. j. van de Kerkhof P.c. m. Kamsteeg M. Seyger M.m. b. Psoriasis dermatitis: an overlap condition of psoriasis and atopic dermatitis in children. Journal of the European Academy of Dermatology and Venereology. 2019; 33: e74-e76 Crossref Scopus (11) Google Scholar ). Newer molecular profiling approaches allow higher resolution analysis and improved classification for such diagnostic dilemmas ( He et al., 2021 He H. Bissonnette R. Wu J. Diaz A. Saint-Cyr Proulx E. Maari C. et al. Tape strips detect distinct immune and barrier profiles in atopic dermatitis and psoriasis. J Allergy Clin Immunol. 2021; 147: 199-212 Abstract Full Text Full Text PDF PubMed Scopus (87) Google Scholar ; Liu et al., 2022 Liu Y, Wang H, Taylor M, Cook C, Martínez-Berdeja A, North JP, et al. Classification of human chronic inflammatory skin disease based on single-cell immune profiling. Science Immunology. American Association for the Advancement of Science; 2022;7(70):eabl9165 Google Scholar ). Here we refine our scRNA-seq based classifier for patient samples of AD, PV, and rashes with overlapping features to improve disease discrimination by optimizing gene programs and statistical performance testing, and also make this approach more accessible to individual investigators.