Advances in Psoriasis Management: From Immunopathogenesis to Targeted Therapies

Abstract

The autoimmune disorder psoriasis is a continual, mediated by antibodies, cutaneous ailment that drastically compromises the way we live and poses a major global health burden. Affecting at least 3% of the globe's inhabitants the condition is characterized by amplification of keratin cells and systemic inflammation driven by dysregulated immune pathways. Key pathogenic mechanisms lead to the triggering of lymphocytes cells (T-lymphocytes) and accessory cells (APCs/DCs), which triggers secretion of inflammatory mediators, notably TNF-α, IL-17 and 22, which perpetuate epidermal hyperplasia. Genetic predisposition, particularly HLA-Cw6 and IL23R variants, in conjunction with stressors from the surroundings these ailments, anxiety, and distress, encourages diseases initialization and progression. Epidemiological data reveal significant range in incidence, from about 0.5 percent in the Asia to 8% in particular regions of the EU, with commencement generally occurring between the aforementioned ages of 15 and 30. The screening process is predominantly clinical, relying on distinctive erythematous plaques featuring silvery scales along with alterations in the nails, corroborated by assessments like the Psoriasis Area and Severity Index (PASI). Topical medications for mild cases, systemic immunosuppressants, biologics that target the TNF-α and interleukin pathways, and newly developed small-molecule inhibitors like deucravacitinib (TYK2 inhibitor) and apremilast (PDE4 inhibitor) are the current therapy approaches. Despite therapeutic advances, psoriasis remains incurable, underscoring the need for continued research into novel targets and personalized treatment approaches.