Comment on ‘Should Paradoxical Psoriasis Trigger Rheumatological Surveillance During IL-4/IL-13 Blockade?’

Lauletta et al. provide important real-world evidence on paradoxical psoriasis and seronegative spondyloarthropathy during IL-4/IL-13 blockade in atopic dermatitis. However, an important unanswered question is whether paradoxical psoriasis represents an early clinical marker of subsequent inflammatory arthritis rather than an isolated adverse event. Clarifying this relationship could inform targeted musculoskeletal surveillance and improve early diagnosis and long-term outcomes.