Psoriasis and Treatment: Past, Present and Future Aspects

Abstract

The management of psoriasis has evolved considerably over the past 100 years. This has occurred in parallel with our understanding of the pathogenesis of this common, complex and enigmatic disease. It should be celebrated as an outstanding example of successful translational research. With precise targeting of immune pathways for the treatment of psoriasis with new biologics and small molecules has come the realisation that the most effective approach to patient management is a holistic one which encompasses the biopsychosocial nature of the disease. This involves a stratified medicine approach to identifying the best drug for an individual allied to patient education, screening for comorbidity, and regular review as both the clinical presentation and the patient's needs will change over time. Al-though there is not yet a cure for psoriasis - the whole person, systems approach to patient management, that is in part dependent on early intervention, should help to ensure an optimal outcome.

Keywords: psoriasis; treatment.

Fig. 1

Advances in the treatment of psoriasis over the past century. This timeline illustrates the major pharmacological advances which have occurred in the management of psoriasis over the past 100 years. It also speculates as to what may be the important therapies in the near future. IL: interleukin; PDE: phosphodiesterase; PUVA: psoralen plus ultraviolet (UV)-A; TNFα: tumour necrosis factor alpha; TYK: tyrosine kinase; JAK: janus kinase.