Eczematous component in psoriasis is possibly a negative prognostic factor for deucravacitinib treatment outcome

Introduction: Eczematized psoriasis is a clinical variant of psoriasis characterized by overlapping features of both psoriasis and eczema. Deucravacitinib is the first oral JAK inhibitor approved for the treatment of moderate to severe plaque psoriasis. The aim of this study was to investigate and compare the efficacy of deucravacitinib in patients with classical and eczematized psoriasis in real world. Methods: Patients with psoriasis who received deucravacitinib therapy in the dermatology department of two German University Medical Centers between 03/2023 and 03/2025 were included in this retrospective study. Treatment outcomes and drug survival of deucravacitinib was assessed with Ka¬plan-Meier analysis. Results: A total of 38 patients were identified (19 with classical psoriasis, and 19 with eczematized psoriasis). Median drug survival of deucravacitinib was numerically higher in classical compared to eczematized psoriasis (21.0 vs. 6.0 months, p = 0.056). Partial or excellent response was more frequently observed in patients with classical psoriasis (68.4% vs. 47.4%). Relapses during treatment occurred significantly more frequently in eczematized than in classic psoriasis (57.9% vs. 26.3%, p = 0.033). Conclusion: The presence of an eczematous component in patients with psoriasis could adversely affect the treatment response to deucravacitinib and should be further investigated.