September 26, 2022

Clinical Letter: Psoriasis or eczema? One-year results from the DGUV research project FB323 with application of the Molecular Classifier in occupational dermatoses

Philipp Bentz, Kilian Eyerich, Elke Weisshaar

First published: 26 September 2022

Dear Editors, hand eczema is a complex and multifactorial skin disease, for which treatment remains challenging . The most im-portant differential diagnosis is psoriasis. An exact diag-nosis is often not possible, due to a similar clinical picture. Moreover, dermatopathohistological analysis often cannot distinguish between the two diseases. This is of great im-portance, however, especially because of differences in syste-mic therapeutic treatment.A few years ago, the development of the Molecular Clas-sifier signified an important step towards an accurate diagno-stic tool able to distinguish psoriasis from eczema with high probability. The disease-specific expression of the genes NOS2 and CCL27 is used for this purpose. With such ex-pression data it was possible to train a classifier that achieved an average accuracy of about 97 % in test cohorts.In occupational dermatology practice, individual cases have shown how molecular diagnostics can positively in-fluence the course of treatment and lead to improvement or healing of the clinical picture. Since November 2020, a patient cohort (N ≥ 282) is being established in the Division of Occupational Dermatology at Heidelberg University Hospital. The aim is to verify whether a diagnosis made with the Molecular Classifier shortens the course of the disease, re-duces therapy costs, reduces sick days, reduces the individual burden of disease, improves health-related quality of life, and enables continued occupational activity in the long term.