Glucagon-like peptide-1 receptor agonists (GLP-1RAs) have transformed the management of obesity, type 2 diabetes mellitus, and cardiometabolic disease through effects on weight reduction, glycemic control, and systemic inflammation. Their varied immunometabolic actions have generated increasing interest in dermatology, where chronic inflammatory skin diseases frequently coexist with obesity, insulin resistance, metabolic syndrome, and cardiovascular disease. Emerging evidence from clinical trials, observational studies, and real-world analyses suggests that GLP-1RAs may improve outcomes in psoriasis, hidradenitis suppurativa, and atopic dermatitis while simultaneously reducing the burden of associated metabolic and cardiovascular comorbidities. In psoriasis, combination therapy with tirzepatide has demonstrated enhanced skin clearance, substantial weight loss, and reduced risk of psoriatic arthritis. In hidradenitis suppurativa and atopic dermatitis, GLP-1RAs have been associated with improvements in cardiometabolic outcomes and reductions in systemic complications. Collectively, these findings support an evolving paradigm in which the greatest therapeutic utility of GLP-1RAs in dermatology may lie not only in direct modulation of cutaneous inflammation but also in addressing the metabolic dysfunction and chronic systemic inflammation that drive disease severity and multimorbidity. We review the current clinical evidence and propose a conceptual framework positioning GLP-1RAs as immune-metabolic therapies that target the systemic comorbidities of inflammatory skin disease, highlighting future opportunities for disease modification and integrated dermatologic care.
