Raj Chovatiya, MD, PhD

Bridging Gut and Skin Care: A Call for Collaboration in Inflammatory Disease Management

As immune-mediated inflammatory diseases continue to blur traditional specialty lines, the intersection between 

 has emerged as a critical—and often underexplored—area of clinical overlap. With growing recognition of shared pathophysiology between chronic skin and gut disorders, from psoriasis and 

, the need for interdisciplinary collaboration has never been greater.

 Special Report, Raj Chovatiya, MD, PhD, a clinical associate professor of medicine at Rosalind Franklin University Chicago Medical School and as founder and director of the Center for Medical Dermatology and Immunology Research in Chicago, and Adelina Hung, MD, a clinical assistant professor at Rosalind Franklin University Chicago Medical School and director of the IBD program at Sinai Health System Chicago, explore the growing clinical and research intersections between dermatology and gastroenterology. Framed by their shared academic background and personal relationship as husband and wife, the conversation offers a detailed, cross-disciplinary look at how immune-mediated diseases of the skin and gut overlap—and how a collaborative care model can enhance outcomes for patients.

The discussion opens with a foundational look at shared pathophysiology. Hung outlines how skin and gut disorders—particularly 

 and chronic inflammatory dermatoses—frequently arise from a common cascade: genetic susceptibility, environmental triggers, barrier dysfunction, and inappropriate immune activation. The biologic parallel between the organs sets the stage for bidirectional comorbidities that she says are now well-documented in systematic reviews and meta-analyses. Patients with IBD, for instance, exhibit higher rates of psoriasis, hidradenitis suppurativa, and atopic dermatitis—and the reverse also appears true.

Chovatiya emphasizes that these overlaps are not just academic but clinically actionable, with dermatologic findings potentially offering visible early clues to underlying GI pathology. Hung notes that dermatologists often see patients before GI symptoms emerge—presenting a critical opportunity for early diagnosis and intervention, particularly in IBD, where prompt initiation of therapy can significantly alter disease trajectory and prevent complications like strictures, fistulas, and colorectal cancer.

Both speakers advocate for proactive, interdisciplinary care to bridge the diagnostic and therapeutic divide. Hung describes how improved communication between specialties could help avoid delayed referrals and disjointed treatment planning. Chovatiya adds that derm and GI often work in parallel without knowing what the other is prescribing, potentially risking polypharmacy, drug interactions, or suboptimal treatment choices.

The conversation then moves into treatment strategy, where both clinicians underscore the therapeutic convergence enabled by modern biologics. Hung highlights how recent years have ushered in an era of expanded treatment options for IBD—including anti-TNFs, integrin blockers, IL-12/23 inhibitors, and JAK inhibitors—which allow for more personalized care. With this expanding toolbox comes a responsibility to coordinate treatment across specialties to manage multimorbidity effectively.

They also discuss the broader barriers to interdisciplinary collaboration. Hung notes that communication between derm and GI is rare in day-to-day clinical practice, especially in systems without integrated specialty care or access to dermatologists. Dermatology referrals can be delayed by months, and cross-consultation is often informal or nonexistent. Chovatiya agrees, pointing out that dermatologists may hesitate to act on signs of GI pathology due to limited training or discomfort initiating care outside their domain. Ultimately, both experts call for increased cross-specialty education at the residency and fellowship level to build clinical confidence and shared language.

Research is another area ripe for cross-disciplinary advancement, with Chovatiya and Hung highlighting the need for clinical trials that enroll patients with multimorbidity and evaluate composite outcomes across organ systems. They advocate for studies that track dual inflammatory biomarkers, patient-reported outcomes, and treatment durability in both derm and GI contexts. Hung points to the emerging role of the microbiome as another shared frontier: while still exploratory, therapies like fecal microbiota transplant and targeted probiotics are already making inroads in GI care and may hold relevance for dermatology in the future.

The conversation closes with a focus on equity and health disparities. Hung emphasizes that patients from underserved communities—such as those seen in urban safety-net systems like hers in Chicago—often experience more complex disease and delayed access to care. For these populations, fragmented specialty care is particularly harmful. Coordinated communication and shared treatment planning are not just best practices—they’re essential to delivering equitable care. Chovatiya adds that addressing disparities will require guidelines that reflect real-world complexity and protocols that enable unified care plans, especially as many newer therapies gain approvals across multiple specialties.

Ultimately, the conversation is a call to action: to reframe siloed care models and instead embrace collaboration as essential to delivering equitable, efficient, and comprehensive care for patients with chronic inflammatory disease.

 has reported serving as an advisor, consultant, speaker, and/or investigator for AbbVie, Amgen, Apogee Therapeutics, Arcutis, Argenx, ASLAN Pharmaceuticals, Beiersdorf, Boehringer Ingelheim, Bristol Myers Squibb, Cara Therapeutics, Dermavant, Eli Lilly and Company, FIDE, Formation Bio, Galderma, Genentech, GSK, Incyte, LEO Pharma, L’Oréal, Nektar Therapeutics, Novartis, Opsidio, Pfizer Inc, Regeneron, RAPT, Sanofi, Sitryx, and UCB. 

Videos

Full video: Experts discuss the overlap between immune-mediated inflammatory diseases in GI and dermatology, emphasizing the importance of cross-specialty care.

Breaking Down Silos: Integrating GI and Dermatology for Inflammatory Disease Care

The Need for Guidelines Related to Patients with GI, Dermatologic Symptoms

 Special Report series, dermatologist Raj Chovatiya, MD, PhD, and gastroenterologist Adelina Hung, MD, the subject of cross-specialty collaboration related to immune-mediated inflammatory diseases in 

 is further explored. Hung serves as director of the IBD Program at Sinai Health System Chicago and a clinical assistant professor at the Rosalind Franklin University Medical School. Chovatiya is a clinical associate professor for Rosalind Franklin University Chicago Medical School and the Center for Medical Dermatology and Immunology Research's director.

During this discussion, Hung and Chovatiya discuss unmet needs in gastroenterology (GI) and dermatology. Hung emphasized the importance of cross-disciplinary training to improve early and accurate diagnosis of comorbid diseases. Chovatiya highlighted the need for standardized guidelines and protocols for co-managing patients with multiple diseases. Both speakers concur on the necessity of addressing disparities in care, particularly among underserved racial and ethnic groups.

They also discuss the need for comprehensive treatment plans and the importance of treating patients as whole-body systems rather than individual organs. The conversation regarding gut health and its relationship with skin health concludes with optimism about future clinical trials that include diverse patient populations and the training of young doctors to recognize findings across specialties.

This summary was created with the help of artificial intelligence tools.

In the final segment of this HCPLive Special Report, experts discuss lingering unmet needs in cross-specialty care and look ahead to potential areas for improvement.

Improving Diagnosis by Addressing Gut Health's Connection to Dermatology

 Special Report series, dermatologist Raj Chovatiya, MD, PhD, and gastroenterologist Adelina Hung, MD, continue their in-depth conversation on cross-specialty collaboration in the care of immune-mediated inflammatory diseases. Hung is the director of the IBD Program at Sinai Health System Chicago and a clinical assistant professor at the Rosalind Franklin University Medical School. Chovatiya serves as a clinical associate professor at Rosalind Franklin University Chicago Medical School and director of the Center for Medical Dermatology and Immunology Research.

This installment of their Special Report series centers on the critical role of early diagnosis and shared therapeutic decision-making in 

. Hung emphasizes that dermatologists are often the first to encounter visible symptoms of gastrointestinal disease, such as in inflammatory bowel disease (IBD).

Prompt recognition and referral can dramatically alter the disease course, as early treatment can prevent complications like strictures, abscesses, and hospitalization. Chovatiya echoes the need for greater diagnostic awareness and highlights the bidirectional association between gut and skin disorders.

The pair discuss the expanding therapeutic landscape, emphasizing that new treatment options in IBD now allow for personalized care that considers comorbidities across specialties. Through case-based examples—including a patient misperceived to be on dual biologics—they illustrate how poor communication between providers can lead to confusion, whereas open dialogue optimizes outcomes.

Hung and Chovatiya also advocate for shared outcome tracking and collaborative research, including microbiome-focused studies and trials enrolling multi-morbid patients. Ultimately, the episode reinforces that interdisciplinary care not only improves patient outcomes, but strengthens trust and continuity across specialties.

In part 2 of their HCPLive Special Report series, Raj Chovatiya, MD, PhD, and Adelina Hung, MD, continue their in-depth conversation.

The Connection Between Gut Health and Dermatologic Diseases

 Special Report series, Raj Chovatiya, MD, PhD, clinical associate professor at Rosalind Franklin University Chicago Medical School and director of the Center for Medical Dermatology and Immunology Research, sits down with his wife, Adalina Hung, MD, a board-certified gastroenterologist and hepatologist. Hung is known for her role as director of the IBD Program at Sinai Health System Chicago and as a clinical assistant professor at the Rosalind Franklin University Medical School.

Together, the duo explores the overlapping immunologic and barrier-based mechanisms shared between dermatologic and gastrointestinal diseases. Hung describes how both the skin and gut serve as immunologically active barrier organs, and how disruption in either can activate similar inflammatory pathways—such as TNF and interleukin (IL)-23—highlighting the clinical overlap seen in conditions like inflammatory bowel disease and psoriasis or hidradenitis suppurativa (HS).

The couple reflects on the bidirectional relationship between skin and GI diseases and stresses the importance of dermatologists recognizing extracutaneous signs of GI disease, including alopecia, dermatitis herpetiformis, or pruritus as potential presenting symptoms. Hung and Chovatiya advocate for increased interdisciplinary collaboration in diagnosis and management, noting that such conversations can lead to better treatment strategies, improved patient education, and more cohesive care across specialties.

In this HCPLive Special Report series, Raj Chovatiya, MD, PhD, and Adelina Hung, MD, discuss the connection between GI and dermatologic care.

Raj Chovatiya, MD, PhD

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