Iron Deficiency in Immune-Mediated Inflammatory Skin Diseases: A Missing Link Between Systemic Inflammation, Immunometabolism, and Disease Burden

    March 2026 in “ Cells ”
    Emilia Kucharczyk, Klara Andrzejczak, Karol Biliński, Matylda Korgiel, Małgorzata Ponikowska
    TLDR Iron deficiency worsens inflammatory skin diseases by disrupting iron balance and increasing inflammation.
    Iron deficiency (ID) plays a crucial yet often overlooked role in the development of immune-mediated inflammatory skin diseases (IMISDs) like psoriasis, atopic dermatitis, and hidradenitis suppurativa. This review highlights how chronic inflammation leads to functional iron deficiency through IL-6–hepcidin-mediated iron sequestration, reducing iron bioavailability and disrupting mitochondrial activity in immune and epithelial cells. This disruption contributes to heightened oxidative and inflammatory responses, advancing inflammation, anemia of chronic disease, and impaired tissue repair. Additionally, evidence suggests an "iron-skin axis," with skin cells, especially epidermal keratinocytes, actively regulating iron pathways, linking iron homeostasis to systemic inflammation, immunometabolic imbalance, and disease burden in IMISDs.
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