Peter Lio, MD, discusses why precision medicine has advanced further in psoriasis than atopic dermatitis, and what oncology can teach dermatology.
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Lio, clinical assistant professor of dermatology and pediatrics at Northwestern University Feinberg School of Medicine and founding director of the Chicago Integrative Eczema Center, described the process as a virtuous cycle in which new medicines deepen understanding of disease biology, which in turn informs the development of better therapies.
Lio contrasted the current state of precision medicine across 2 major inflammatory skin diseases. In psoriasis, he noted treatment has advanced substantially, though true personalization remains limited, largely because available agents are effective enough for most patients without requiring tailored selection. In atopic dermatitis, Lio said outcomes remain less consistent, reflecting continued unmet need and a case for more sophisticated diagnostic testing.
Lio said current testing tools remain narrowly focused on single pathways, limiting clinicians' ability to distinguish between patients whose disease is driven primarily by skin barrier dysfunction, inflammatory pathway activity, microbiome disruption, or a combination of factors. He noted atopic dermatitis may ultimately resist full personalization due to its multifactorial nature, requiring a more holistic treatment approach even as future therapies continue to improve outcomes broadly.
Lio identified oncology as the field furthest along in precision medicine, citing its ability to match specific tumor mutations to targeted pathway-based therapies. He said inflammatory skin diseases remain considerably messier and more complex by comparison, which he noted makes them more scientifically interesting despite the added difficulty. Lio also highlighted the growing evidence base behind over-the-counter dermatologic products, including cleansers and moisturizers, describing their scientific development as a parallel renaissance that receives less attention than prescription drug advances.
Reflecting on the evolution of precision medicine, Lio noted early enthusiasm stemmed from single-gene, single-protein genetic diseases, which initially suggested a broader medical revolution before more complex, multifactorial conditions revealed the limits of that model. He expressed continued optimism precision medicine will eventually extend to complex inflammatory diseases as understanding of their multiple contributing pathways matures.
Editor's Note: This transcript has been edited for grammar and clarity using artificial intelligence tools. Lio had no relevant disclosures of note.
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