A large number of Americans suffer from chronic inflammatory skin conditions with no identifiable cause and limited treatment options beyond symptom management. However, a new study may pave the way for precision medicine-based diagnostic tests and targeted therapies.

In a recent paper published in Scientific Reports, a Nature journal, researchers from the University of Maryland School of Medicine (UMSOM) detailed the discovery of a previously unidentified skin disease in a male patient with erythroderma. The condition caused severe inflammation, covering 80% of his body with red, peeling skin lesions that burned and itched. Despite months of conventional treatment including the steroid prednisone, anti-itch creams, and immunosuppressive drugs the patient experienced little relief.

We developed a novel blood test using flow cytometry to analyze individual circulating blood cells and identify specific cytokine signatures, explained the study’s corresponding author, Dr. Shawn Kwatra, Joseph W. Burnett Endowed Professor and Chair of Dermatology at UMSOM, and Chief of Service Dermatology at the University of Maryland Medical Center (UMMC). The researchers patented this method, which enabled them to identify a previously unknown and potentially life-threatening form of erythroderma.

Erythroderma is a rare but severe inflammatory condition that affects most of the body’s skin. It leads to widespread redness, scaling, and skin peeling, which can disrupt the body’s ability to regulate temperature and cause protein and fluid loss, potentially leading to severe complications.

To pinpoint the immune components driving this patient’s disease, Dr. Kwatra and his team used their patented flow cytometry-based immunophenotyping technique. They discovered that two cytokines interleukin-13 (IL-13) and interleukin-17 (IL-17) were elevated in this patient compared to both healthy individuals and patients with other known types of erythroderma. Based on these findings, they initiated targeted treatment using biologic inhibitors of IL-13 and IL-17, which successfully reversed the patient’s condition.

We identified a new role for interleukin-13 and interleukin-17 in this patient’s blood, which justified the use of medications targeting these cytokines, said study first author Dr. Hannah Cornman, an incoming dermatology resident at the University of North Carolina, who conducted the research as a medical student at UMSOM. These cytokines were the key drivers of the disease.

The patient was treated with a combination of two monoclonal antibodies dupilumab and secukinumab which led to a dramatic reduction in symptoms, ultimately resolving the disease. The researchers also identified the cell sources of these pathogenic cytokines and tracked the decline in disease-causing cell populations as well as reductions in IL-13 and IL-17 levels throughout the course of treatment.

We developed a new diagnostic test that allowed us to identify a previously unknown skin disease and initiate effective treatment. We are now working on expanding this diagnostic approach to other inflammatory skin conditions, Dr. Kwatra added.

The study was supported by funding from the National Institutes of Health, with contributions from researchers at Duke University School of Medicine, George Washington University School of Medicine, and Johns Hopkins University School of Medicine.

source: https://www.medschool.umaryland.edu/news/2025/um-school-of-medicine-dermatology-researchers-discover-new-skin-disease-using-innovative-diagnostic-platform.html