Proposing an immune-inclusive lens to the new epidermal differentiation disorders classification

We commend the structural and mechanistic clarity offered by the new pathogenesis-based classification for inherited epidermal differentiation disorders (EDDs), while proposing a complementary immunological dimension – epidermal differentiation disorders with immune dysregulation (EDDID). Drawing on emerging data from ichthyosis and parallels with inflammatory dermatoses like atopic dermatitis and psoriasis, we suggest that recognizing immune endotypes within this framework may enhance diagnostic precision and expand therapeutic horizons.