Psoriasis: Challenges, therapeutic advances, and perspectives in the treatment of a chronic inflammatory disease

Abstract

Psoriasis is a chronic, inflammatory skin disease that affects between 2 and 3% of the world's population. This condition is characterized by a dysfunction of the immune system that causes abnormal cell growth in the epidermis, resulting in the formation of thick, red, scaly plaques on various areas of the body, especially the elbows, knees, and scalp. Although the exact cause of psoriasis is not yet fully understood, it is believed to result from a complex interaction between genetic and environmental factors. Research has shown that genetic predisposition plays a key role in the development of the disease, as multiple genes are associated with psoriasis, especially those related to the immune system, such as genes that code for pro-inflammatory cytokines. In addition to genetic factors, various environmental factors can trigger or aggravate psoriasis in predisposed individuals. These factors include stress, infections, cold and dry weather, the use of certain medications, and alcohol consumption. Advances in research in recent years have allowed a deeper understanding of the underlying immunological mechanisms, highlighting the involvement of T cells and inflammatory cytokines, which has expanded our understanding of the pathophysiology of the disease. The characteristic cutaneous lesions of psoriasis include well-demarcated plaques of thickened skin, scaling, and redness, and can vary in severity, from mild forms affecting limited areas of the skin to severe forms that involve large areas of the body and impact patients' quality of life. In addition to cutaneous manifestations, psoriasis is often associated with systemic inflammatory diseases, one of the most common being psoriatic arthritis. This inflammatory joint disease can cause pain, stiffness, and joint damage, increasing the disease burden for patients. The identification of molecular signaling pathways involved in the pathogenesis of psoriasis has revolutionized the treatment of the disease.