A spatial transcriptomics analysis of psoriasis finds that mild and severe forms of the condition have different molecular features. Psoriasis, an inflammatory skin disease, leads to thickness, redness, and scaliness of the skin, and a portion of those with psoriasis may develop psoriatic arthritis and other conditions. In Science Immunology, researchers from NYU Langone Health and elsewhere examined the cellular composition, localization, and interactomes of 25 skin samples from 11 people with mild to severe psoriasis and from three healthy adults without psoriasis using a spatial transcriptomic approach. Their analysis uncovered differences in immune microniches in the healthy versus affected skin and in particular noted an enrichment of B lymphocytes in lesions. Further, unsupervised classification found the samples segregated by disease severity due to differences in dermal macrophage and fibroblast clusters, lymphatic epithelium, and pathways associated with metabolic dysregulation. In a statement, study author Jose Scher, a rheumatologist at NYU, says the team's goal was to find molecular signals to help them determine who was more likely to develop severe psoriasis or related complications. "Having found signals with potential systemic consequences, we are now working to understand how skin inflammation can lead to widespread disease affecting other organs," he adds.