You will be presented with the full text of a biomedical research paper. Please write an abstract for this paper. Your response should include the abstract and no additional text.

Paper text:
while the efficacy of tumor necrosis factor ( tnf)- inhibitors for the treatment of chronic plaque psoriasis has been well established , their therapeutic benefits in atopic dermatitis ( ad ) has remained controversial [ 1 , 2 , 3 ] .
in addition , some reports , including large case series , have even described the induction of eczematous and ad - like lesions by tnf- inhibitors and have advised against their use in patients with an atopic constitution and eczema [ 4 , 5 , 6 , 7 ] .
we here report a case on the management of psoriasis associated with ad using adalimumab .
a 55-year - old man with long - standing severe recalcitrant plaque psoriasis was treated with an 80-mg loading dose of adalimumab , and thereafter 40 mg every other week .
the patient had an atopic constitution with a personal history of allergic rhinoconjunctivitis and asthma , and he was concomitantly suffering from slightly active ad in his armpits .
after 3 months of therapy with adalimumab , a marked improvement of his psoriasis ( pasi 75 response ) was observed ( fig .
however , together with this improvement , new eczematous lesions had begun to flare up on his neck , armpits , and hands ( fig .
his atopic constitution was further substantiated by positive skin prick tests to house dust mites , cats , grass and birch pollen as well as by raised total ige levels ( 253 ku / l ; normal value < 100 ku / l ) .
therapy with adalimumab was continued due to a beneficial response of the psoriatic lesions , while the eczematous lesions were temporarily treated with topical corticosteroids ( mometasone ointment for 3 weeks daily and twice weekly thereafter ) .
the topical corticosteroids were discontinued after 6 weeks . together with further amelioration of the psoriatic lesions ( fig .
1c ) , a marked improvement of his ad was subsequently also observed during the following 5 months ( fig .
the clinical and pathophysiological features between psoriasis and ad differ substantially and an inverse association of both diseases has also been reported [ 8 , 9 , 10 , 11 ] .
although the simultaneous occurrence of both diseases appears to be rare , few patients , as described in this case , may concomitantly have psoriasis and ad .
indeed , genomic studies indicate that psoriasis and ad may have a couple of shared genes which regulate the proliferation and differentiation of epidermal cells and modulate general cutaneous inflammatory mechanisms [ 12 , 13 ] . in addition
, both diseases are characterized by t - cell - dominated dermal infiltrates and a good responsiveness to t - cell - directed agents .
recent studies have further delineated the phenotype of the infiltrating t cells in psoriasis and ad [ 10 , 11 ] . while psoriasis is mainly mediated by th1 and th17 cells ,
, th1 cells producing cytokines like ifn- and tnf- are also thought to contribute to the chronic phase of ad .
the recognition of tnf- as a key regulator of inflammation in general and its possible involvement in the development of chronic ad lesions also led to the use of tnf- inhibitors in ad .
while some reports have failed to show substantial beneficial responses , others have demonstrated successful treatment of recalcitrant ad by tnf- inhibitors [ 1 , 2 , 3 ] .
although a flare - up of ad was initially noted in our patient , therapy with adalimumab could be continued and ultimately lead to amelioration of both psoriasis and ad . to our knowledge , this is the first case reporting the successful management of psoriasis associated with ad using adalimumab . as noted in our case , some reports , including large case series , have also described the induction of eczematous and ad - like lesions by tnf- inhibitors [ 4 , 5 , 6 , 7 ] .
these eczematous eruptions were either newly developed or flared up in patients with an atopic constitution .
most of these ad - like reactions were of moderate intensity and were managed well with topical corticosteroid or calcineurin inhibitors [ 5 , 6 ] , although severe cases necessitating hospitalization or discontinuation of treatment have also been reported . in conclusion , physicians should be aware that eczematous lesions may flare up during the therapy with tnf- inhibitors , especially in patients with an atopic constitution .
however , these flares can often be managed without withdrawing the tnf- inhibitor and by using topical corticosteroids .
furthermore , based on some similarities in the inflammatory process of both chronic ad and psoriasis , as well as the encouraging therapy results in at least some cases , tnf- inhibitors may even be beneficial for patients with severe ad at a chronic stage .
tumor necrosis factor- inhibitors may induce various cutaneous side effects including eczematous - like lesions . the management of such side effects can be challenging . 
 herein , we report a case of a 55-year - old man who had a flare - up and subsequent improvement of atopic dermatitis during treatment of severe psoriasis with adalimumab .