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Review
. 2025 Feb 16;17(2):e79097.
doi: 10.7759/cureus.79097. eCollection 2025 Feb.

Therapeutic Advancements in the Management of Psoriasis: A Clinical Overview and Update

Sarah F Qasem  1 , Hasan Ashkanani  1 , Ali Ali  2
Affiliations
Review

Therapeutic Advancements in the Management of Psoriasis: A Clinical Overview and Update

Sarah F Qasem et al. Cureus. .

Abstract

Psoriasis is an autoimmune chronic inflammatory skin condition with a strong genetic predisposition. Pathogenesis of psoriasis is complex and multifactorial; it is known that genetic, immunological, and environmental factors play significant roles in its development. Treatment options vary and include topical therapy (e.g., corticosteroids, vitamin D analogs, and calcineurin inhibitors), phototherapy (e.g., narrowband ultraviolet radiation (NB-UVB)), and systemic therapy (e.g., methotrexate and retinoids). Several new treatments have emerged in recent years, including biological treatments. Biologics approved by the United States Food and Drug Administration (FDA) for the treatment of psoriasis include inhibitors of tumor necrosis factor (TNF)-α. Other FDA-approved biologics for the treatment of psoriasis target cytokines, such as the p40 subunit of interleukin (IL)-12 and IL-23, IL-17, as well as the p19 subunit of IL-23. Additionally, the Janus kinase (JAK) inhibitor deucravacitinib is also FDA-approved for the treatment of moderate-to-severe psoriasis. Other promising treatment modalities are consistently undergoing trials. Further therapeutic details, including regimens, side effects, indications, contraindications, and FDA approval dates, are discussed comprehensively in this article. For the purpose of this review, the literature was thoroughly searched for publications discussing psoriasis therapy. This review aims to provide a comprehensive overview and update on the management of psoriasis.

Keywords: biologics; management; nails; psoriasis; skin.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Topical corticosteroid potency chart
Topical corticosteroid classification based on potency, with class 1 being the most potent. Credits: Author Hasan Ashkanani
Figure 2
Figure 2. Phototherapy as first, second, and third line treatment for psoriasis
Phototherapy options as a treatment for psoriasis. NB-UVB: Narrowband ultraviolet B; BSA: Body surface area; PUVA: Psoralen ultraviolet A; PDL: Pulsed dye laser; PDT: Photodynamic therapy; LED: Light-emitting diodes; He-Ne: Helium-Neon; IPL: Intense pulsed light; PUVB: Psoralen ultraviolet B Credits: Author Hasan Ashkanani
Figure 3
Figure 3. Biologics used in the management of psoriasis
Biologics with their targets, including IL action sites and TNF. TNF: Tumor necrosis factor; TNFR: Tumor necrosis factor receptor; IL: Interleukin; Th17: T-helper 17 cell; ILC3: Innate lymphoid cell type 3 Credits: Author Ali Ali
See this image and copyright information in PMC

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