Psoriasis Treatment Paradigms: Progress, Challenges, and Future Trends in Bridging Clinical Practice and Emerging Research

Psoriasis is a lifelong inflammatory skin condition affecting about 2-3% of people worldwide. It shows up as red, scaly patches on the skin due to overactive immune cells and fast skin cell growth. The main causes include genes, infections, stress, and immune signals like TNF-α, IL-17, IL-23, and IFN-γ that lead to swelling and thick plaques. Current treatments span topical agents (corticosteroids, vitamin D analogues, calcineurin inhibitors, retinoids, coal tar), phototherapy (NB-UVB, PUVA, excimer laser), and systemic therapies (methotrexate, cyclosporine, apremilast, biologics targeting TNF/IL-17/IL-23 axes), yet challenges persist including side effects, tachyphylaxis, high costs, and absence of cure. The disease also links to heart problems, diabetes, and mental health challenges. Emerging trends emphasize personalized therapies, targeted biologics, and bridging research gaps to improve efficacy, safety, and quality of life amid significant socioeconomic burdens.