This review outlines the current psoriasis treatment landscape, noting that care is generally guided by disease severity. Mild psoriasis usually is managed with topical therapies such as corticosteroids, vitamin D analogs, calcineurin inhibitors, keratolytics, and targeted phototherapy. Moderate-to-severe disease typically requires systemic treatment, including phototherapy, oral agents, and biologics. Among systemic options, biologics targeting TNF-α, IL-23, and IL-17 have shown strong efficacy, often outperforming oral therapies and phototherapy, though each class carries distinct safety considerations. Despite these advances, important challenges remain in psoriasis care. These include primary and secondary treatment failure, high drug costs, and limited evidence to guide optimal combination strategies. There also are ongoing unmet needs in difficult-to-treat subtypes such as scalp, nail, genital, palmoplantar, and generalized pustular psoriasis.

Looking ahead, the review highlights several promising directions that could reshape psoriasis care. Emerging therapies include new IL-23 inhibitors, selective TYK2 inhibition, IL-36-targeted treatments, RORγt inhibitors, and ROCK2 inhibitors, all aimed at more precise control of psoriatic inflammation. The article also points to advances in topical drug delivery, including microneedles, nanoparticles, nanofibers, and hydrogels, which may improve local efficacy while reducing systemic side effects. In parallel, biomarker research and multi-omics approaches may eventually support more personalized treatment decisions by helping predict disease severity, treatment response, and comorbidity risk. Overall, the authors conclude that psoriasis management is moving toward more targeted, individualized, and potentially more effective care, though cost, resistance, and real-world implementation challenges still need to be addressed.

Reference: Lee HJ, Kim M. Challenges and Future Trends in the Treatment of Psoriasis. Int J Mol Sci. 2023 Aug 28;24(17):13313. doi: 10.3390/ijms241713313. PMID: 37686119; PMCID: PMC10487560.

This psoriasis treatment page from the American Academy of Dermatology explains that psoriasis is best diagnosed and managed by a board-certified dermatologist. That evaluation may include examining the skin, scalp, and nails and asking about symptoms, family history, joint pain or stiffness, nail changes, and possible triggers such as illness, medications, or stress. In some cases, a skin biopsy may be performed to help confirm the diagnosis or rule out other conditions that can resemble psoriasis. Accurate diagnosis is especially important because psoriasis can appear differently across skin tones and may involve more than the skin alone, with some patients also developing psoriatic arthritis or other related health concerns. Early recognition can help ensure that patients receive appropriate treatment and monitoring before the disease has a greater impact on quality of life.

Treatment is individualized based on the type, severity, and location of psoriasis, along with how much it affects daily life and the patient’s broader medical history, current medications, and personal treatment goals. Management options may include topical therapies, light therapy, and systemic treatments such as methotrexate, cyclosporine, biologics, apremilast, acitretin, and TYK2 inhibitors. Because psoriasis can change over time and no single therapy works for everyone, patients may need different treatments or combinations of treatments as their disease evolves. Ongoing follow-up is an important part of care, allowing clinicians to adjust therapy, monitor for side effects and comorbidities, screen for psoriatic arthritis, and help patients manage flare-ups and expectations over the long term.

Reference: Ludmann P. Psoriasis: Diagnosis and treatment. American Academy of Dermatology Association. Updated July 16, 2025. Accessed March 26, 2026. https://www.aad.org/public/diseases/psoriasis/treatment/treatment

This summary highlights how the Janus kinase-signal transducer and activator of transcription (JAK–STAT) pathway drives inflammatory signaling central to psoriasis, with key cytokines (notably IL-12/23 and interferons) relying on JAK family members—including TYK2—to activate downstream gene transcription that sustains chronic inflammation and keratinocyte hyperproliferation. While biologics remain foundational for moderate-to-severe disease, the field is rapidly expanding into oral small-molecule JAK inhibitors, with the review emphasizing the scientific rationale and clinical momentum behind targeting TYK2 to modulate core psoriatic pathways without the broader immunosuppression seen with earlier JAK agents.

The article traces the evolution from first-generation pan-JAK inhibitors (effective but limited by safety concerns such as infection, thrombosis, and malignancy warnings) to more selective second-generation agents, and then to third-generation allosteric TYK2 inhibitors that bind the TYK2 pseudokinase (JH2) domain for greater specificity. Deucravacitinib is positioned as the first FDA-approved allosteric TYK2 inhibitor for moderate-to-severe plaque psoriasis, with TAK-279 and others advancing in development. Looking ahead, the review flags TYK2 degraders (e.g., KT-294) as a potential next step—aiming to eliminate the TYK2 protein rather than inhibit it—while underscoring remaining practical questions around long-term control, real-world safety/durability, and how TYK2-targeted therapies should be sequenced or combined with biologics.

Reference: Lightowler J. The Rise of JAK Inhibitors in Psoriasis—Targeting the JAK-STAT Pathway for Precision Treatment. Dermatology Insights (Substack). 2025 Jun 30.

Short-term, high-dose induction with risankizumab (an IL-23 inhibitor) produced durable plaque psoriasis control in a small proof-of-principle study, alongside a marked reduction in skin resident memory T cells (TRM). Among 20 adults randomized to 300 mg or 600 mg (given at baseline, Week 4, and Week 12/16 per the report), most achieved strong clinical responses through 52 weeks: 83% reached Psoriasis Area and Severity Index (PASI) 75, >60% reached PASI 90, and 43% reached PASI 100. Biopsies and single-cell analyses showed that lesional skin at baseline contained many T-cell populations, but by Week 52 the treated lesional skin looked more like nonlesional skin, with TRM—including IL-17–producing TRM17—significantly reduced (reported P=0.04). The higher dose appeared to more completely deplete T cells in tissue, though overall clinical efficacy looked similar between dose groups.

The investigators framed the findings as supportive of a “hit hard, hit early” hypothesis: if TRM help drive recurrence at the same sites, reducing/eradicating these cells via IL-23 blockade might extend remission after treatment withdrawal—potentially more so in patients with shorter disease duration. However, the presenter cautioned this is not a cure. Some patients remained clear well into year 2, while others gradually relapsed. The authors emphasized that larger prospective studies are needed to confirm whether high-induction regimens can reliably induce longer remissions and to better define durability, optimal dosing, and patient characteristics linked to sustained clearance.

Reference: Bankhead C. Short-Term High-Dose Psoriasis Therapy Shows Potential for Long-Term Disease Control. MedPage Today. Published March 13, 2024. Accessed January 27, 2026. https://www.medpagetoday.com/meetingcoverage/aad/109148?xid=nl_mpt_morningbreak2024-03-14&eun=g1443091d0r&utm_source=Sailthru&utm_medium=email&utm_campaign=MorningBreak_031424&utm_term=NL_Gen_Int_Daily_News_Update_active

The LITE (Light Treatment Effectiveness) study, published in JAMA Dermatology, found that home narrowband UVB (nbUVB) phototherapy can improve psoriasis about as well as in-clinic phototherapy—while being easier for many patients to stick with. In the trial of 783 participants (ages 12+ with plaque or guttate psoriasis), patients were randomized to 12 weeks of at-home vs in-office nbUVB, then followed for an additional 12-week observation period. Overall, 33% of home-treated patients vs 26% of in-office patients were clear or almost clear at 12 weeks; and among patients in either group who were able to maintain the recommended twice-weekly schedule, about 60% achieved clear or almost clear skin.

A key difference was adherence and practicality: patients treated at home were more than three times as likely to maintain the twice-weekly frequency, avoiding the time and cost burden of office visits (about 50 minutes of travel time and ~$20 in travel costs per treatment, on average). Devices used at home deliver therapeutic UV wavelengths (not the cancer-associated wavelengths typical of commercial tanning beds), and some participants also used systemic meds/biologics during the study. No one discontinued due to adverse effects, results were consistent across skin types (with home doing better largely because of consistency), and the authors argued insurers should reduce barriers and delays for coverage so clinicians can prescribe home phototherapy when medically appropriate and aligned with patient preference.

Reference: Gardner A. Psoriasis patients can get clearer skin with at-home treatment instead of at doctors' offices, study suggests. Medical Xpress. Published October 26, 2024. Accessed January 27, 2026. https://medicalxpress.com/news/2024-10-psoriasis-patients-clearer-skin-home.html

Tremfya (guselkumab) has received expanded FDA approval to treat children aged 6 years and older who weigh at least 40 kg and have moderate to severe plaque psoriasis or active psoriatic arthritis, making it the first IL-23 inhibitor approved for pediatric patients with these conditions. The decision was based on the phase 3 PROTOSTAR trial, where more than half of treated children achieved major skin clearance by week 16: about 56% reached Psoriasis Area Severity Index (PASI) 90 and 66% achieved Investigator’s Global Assessment (IGA) 0/1, with around 40% attaining complete skin clearance, all substantially higher than placebo. Adverse events were reported less frequently with Tremfya than with placebo, with nasopharyngitis, upper respiratory tract infection, and COVID-19 among the most common events.

This approval helps address a significant unmet need in pediatric psoriasis and psoriatic arthritis, which can greatly affect physical functioning, emotional well-being, and social participation during formative years. Psoriasis affects millions worldwide, with up to one-third of cases beginning in childhood and about 30% of patients eventually developing psoriatic arthritis, contributing to substantial personal and economic burden. Tremfya, a fully human monoclonal antibody targeting the IL-23 p19 subunit and CD64, was already approved for adults with plaque psoriasis, psoriatic arthritis, ulcerative colitis, and Crohn’s disease, including both subcutaneous and intravenous induction options in Crohn’s. Clinicians and advocacy groups view the pediatric indication as an important step forward, offering an additional targeted option within a limited pediatric treatment landscape.

Reference: James D. FDA Approves Tremfya for Children With Plaque Psoriasis, Psoriatic Arthritis. Pharmaceutical Executive. Published September 29, 2025. Accessed December 9, 2025. https://www.pharmexec.com/view/fda-tremfya-children-plaque-psoriasis-psoriatic-arthritis

Psoriasis is a chronic, immune-mediated disease in which biologic therapies like secukinumab have become key options for patients with moderate to severe plaque involvement. However, as more patients remain on these agents long term, questions around if, and when, to safely taper doses are increasingly important for both clinical and economic reasons. In this retrospective study, 75 patients who had received secukinumab 300 mg weekly for 5 weeks and then every 4 weeks, and maintained a Psoriasis Area and Severity Index (PASI) 90 response for at least 6 months, were evaluated for tapering outcomes. Of these patients, 40 (53.3%) successfully tapered their secukinumab dose while maintaining adequate disease control. No serious adverse events were reported during the observation period.

Several factors emerged as predictors of successful tapering. Lower BMI, earlier initiation of tapering after achieving PASI 90, and a longer period of stable treatment before dose reduction were all associated with higher success rates. Seasonal patterns also appeared relevant: taper attempts made in autumn and winter were more likely to fail, while those in spring and summer had better outcomes. Rapid achievement of PASI 90 early in therapy further correlated with successful tapering, suggesting that patients with robust initial responses may be better candidates for dose reduction. Together, these findings support the idea that, under the right clinical conditions and careful monitoring, secukinumab dose tapering can be a feasible way to maintain psoriasis control while potentially lowering treatment burden, costs, and long-term risk of adverse effects.

Reference: Chen J, Xiao Z, Zeng X, et al. Predictors of Successful Secukinumab Dose Tapering in Moderate-to-Severe Psoriasis: A Retrospective Study. Psoriasis (Auckl). 2025 Oct 17;15:527-534. doi: 10.2147/PTT.S531447. PMID: 41133130; PMCID: PMC12540611.

This review synthesizes current knowledge on psoriasis, from its diverse clinical subtypes to the molecular pathways that drive disease and inform therapy. It outlines major forms—including plaque, guttate, pustular, erythrodermic psoriasis, and psoriatic arthritis—highlighting morphology, distribution, systemic risks, and quality-of-life impact. Histologically, psoriatic lesions show epidermal hyperplasia, parakeratosis, Munro microabscesses, vascular changes, and dense T cell–rich inflammation. Pathogenesis is organized around key immune and signaling pathways—the IL-23/Th17 axis, CCL20–CCR6–mediated T-cell trafficking, NF-κB, JAK/STAT (including TYK2), and PI3K/AKT–mTOR–FoxO—converging on keratinocyte hyperproliferation and chronic inflammation. Diagnosis still relies primarily on clinical examination, supported by dermoscopy, histology, and severity metrics such as Psoriasis Area and Severity Index.

The review then surveys current therapies—oral agents (methotrexate, cyclosporine, retinoids, apremilast), injectables (traditional immunosuppressants and biologics targeting TNF-α, IL-12/23, IL-23, IL-17, IL-36R), and topical treatments (vitamin D analogs, corticosteroids, calcineurin inhibitors, coal tar). To address barrier dysfunction and hyperkeratosis that limit penetration, the authors focus on emerging transdermal systems: nanotechnology-based carriers (metal, polymer, lipid), microneedles, and dressing-based platforms (gels, electrospun nanofibers). These approaches aim for deeper, more controlled, and more targeted delivery with fewer systemic side effects but face hurdles in scale-up, stability, and cost. Looking ahead, the review stresses the need for better biomarkers, continued exploitation of signaling targets such as TYK2, and translation of novel delivery technologies into scalable, patient-friendly therapies that can reduce the long-term clinical and economic burden of psoriasis.

Reference: Gao Y, Xu T, Wang Y, et al. Pathophysiology and Treatment of Psoriasis: From Clinical Practice to Basic Research. Pharmaceutics. 2025;17(1):56. doi: 10.3390/pharmaceutics17010056.

Researchers of a multicenter, retrospective study of 1024 adults with moderate-to-severe psoriasis treated with guselkumab (2019-2024) showed rapid and durable skin clearance in routine practice. Mean Psoriasis Area and Severity Index (PASI) scores fell from 14.3±8.8 at baseline to 1.3±2.4 at 6 months and remained low from 12 to 60 months (≈1.0–1.3). Drug survival was high, with Kaplan–Meier estimates of 95.85%, 91.73%, 89.74%, 87.08%, and 85.76% at 12, 24, 36, 48, and 60 months, respectively.

Response was attenuated in several subgroups: patients with prior biologic exposure, those with obesity, and those switched from anti-IL-17 therapies had significantly lower PASI responses across time points. In multivariable models, previous biologic use and obesity were consistent negative predictors of achieving PASI 75/90/100; cardiovascular disease predicted lower odds of PASI 90 at 3 months (OR 0.64, 95% CI 0.42–0.97). Risk of discontinuation was higher in females, individuals with ≥3 prior biologics, longer disease duration, and prior anti-IL-17 therapy, while overall comorbidity burden did not significantly affect discontinuation. Overall, guselkumab demonstrated sustained long-term effectiveness and persistence, with patient history and metabolic factors informing prognosis. As a retrospective, nonrandomized analysis, these findings may be influenced by selection bias, unmeasured confounding, and missing data, and safety outcomes were not detailed.

Reference: Mortato E, Talamonti M, Marcelli L, et al. Long-Term Real-World Effectiveness and Drug Survival of Guselkumab in Patients with Psoriasis: A 5-Year Retrospective Study. Psoriasis (Auckl). 2025;15:455-469. doi: 10.2147/PTT.S533005.

Researchers explored the potential of using a selective TYK2 inhibitor, BMS-986165, as a topical treatment for psoriasis—a novel approach compared to its recently approved oral formulation. Using a mouse model of imiquimod-induced psoriatic dermatitis, researchers applied a 1.5% BMS-986165 ointment to evaluate its therapeutic effects. The topical formulation significantly reduced psoriasis-like symptoms and inflammation. Single-cell RNA sequencing and flow cytometry revealed that keratinocytes —key skin cells in psoriasis—were major targets of the topical TYK2 inhibitor.

Further in vitro experiments showed that inhibiting TYK2 disrupted the AKT-SP1 signaling pathway, leading to decreased expression of the nerve growth factor receptor and reduced activation of AP1, a protein complex involved in proinflammatory signaling. These findings suggest that topical TYK2 inhibition directly reduces the inflammatory capabilities of keratinocytes, a key driver of psoriasis. This research highlights a promising new route for psoriasis treatment via topical TYK2 inhibition and uncovers a previously underexplored mechanism in keratinocyte-driven inflammation.

Reference: Fang Z, Jiang R, Wang Y, et al. Topical TYK2 inhibitor ameliorates psoriasis-like dermatitis via the AKT-SP1-NGFR-AP1 pathway in keratinocytes. Clin Transl Med. 2025 Mar;15(3):e70256. doi: 10.1002/ctm2.70256. PMID: 40038877; PMCID: PMC11879890.

Patients with psoriasis have an increased risk of suicidal ideation and behavior (SIB) and depression. Bimekizumab, an interleukin (IL)-17A and IL-17F inhibitor, was approved for the treatment of moderate to severe plaque psoriasis by the FDA in 2023 and by the European Medicines Agency in 2021. This study aimed to evaluate the incidence of SIB and depression in patients treated with bimekizumab across nine clinical trials for moderate to severe psoriasis, using the Columbia-Suicide Severity Rating Scale and Patient Health Questionnaire-9, with assessments overseen by an independent Neuropsychiatric Adjudication Committee.

Results showed that, more than 7166 patient-years (PY) of exposure to bimekizumab, the adjudicated SIB rate was 0.13 per 100 PY, within the range observed for the general psoriasis population (0.09-0.54 per 100 PY) and comparable to other anti-IL-17A/anti-IL-23 therapies (0.09-0.19 per 100 PY). By week 16, 92.9% of bimekizumab-treated patients reported no or minimal depression, compared to 81.1% of placebo-treated patients. Overall, bimekizumab-treated patients had low levels of new-onset SIB and depression, indicating that the therapy does not significantly increase mental health risks in this population.

Reference: Blauvelt A, Armstrong A, Merola JF. Mental health outcomes in patients with moderate to severe psoriasis treated with bimekizumab: Analysis of phase 2/3 randomized trials. J Am Acad Dermatol. 2024 Jul;91(1):72-81. doi: 10.1016/j.jaad.2024.02.039. Epub 2024 Mar 4. PMID: 38447700.

Researchers at the University of Copenhagen have developed a patch designed to make psoriasis treatment easier and more effective. Psoriasis, a common inflammatory skin condition affecting about 4% to 5% of the Danish population, is typically treated with creams and ointments. However, these treatments often require multiple daily applications and can leave the skin feeling greasy, leading to inconsistent use. The new patch, which only needs to be applied once a day, aims to address these issues by offering a more comfortable treatment option for patients with psoriasis.

The patch contains two active ingredients, salicylic acid and hydrocortisone, which are released at different rates to address different aspects of psoriasis treatment. Salicylic acid works immediately to remove dead skin cells, while hydrocortisone helps reduce inflammation over time. Tested on pig skin and human skin cells, the patch showed similar effectiveness to traditional treatments. The patch, made using electrospinning to create synthetic nanofibers, holds potential not only for psoriasis but also for treating other inflammatory skin conditions, such as atopic eczema, and may even aid in wound healing. However, further research and clinical trials are needed before it can be made widely available.

Reference: University of Copenhagen - The Faculty of Health and Medical Sciences. Researchers develop nanofiber patch for treatment of psoriasis. ScienceDaily. Published November 12, 2024. Accessed March 22, 2025. https://www.sciencedaily.com/releases/2024/11/241112123220.htm. 

A recent cross-sectional study explored the correlation between psoriasis treatment using biologics and Demodex mite density. The study, conducted from May to June 2023, compared Demodex mite density in patients with psoriasis undergoing biologic treatment with those receiving no treatment or topical therapy. Utilizing the skin surface biopsy technique, the researchers observed significantly higher Demodex mite density and prevalence of demodicosis among patients treated with biologics, particularly evident on the cheeks and forehead.

The findings suggest a potential link between biologic therapy and increased Demodex density in patients with psoriasis, highlighting the need for further investigation and interventions to mitigate the risk of demodicosis in immunosuppressed individuals. These results contribute to understanding the complex interaction between immune modulation therapies and Demodex colonization, offering insights for future research and clinical management strategies.

Reference: Smith T. Demodex Mite Density Increases in Psoriasis Patients Treated with Biologic Therapy. HCPLive. Published April 29, 2024. Accessed May 7, 2024. https://www.hcplive.com/view/demodex-mite-density-increases-in-psoriasis-patients-treated-with-biologic-therapy?utm_source=www.hcplive.com&utm_medium=relatedContent

An analysis reviewed the current research on psoriasis, exploring various aspects of the condition. A 2020 systematic review highlighted that abnormalities in the gut microbiome, such as unusual colonization by specific bacteria, might contribute to psoriasis. Although there's no consensus yet on how these changes impact the condition, future research into the gut microbiome and potential interventions like probiotics could provide new avenues for psoriasis prevention and treatment. 

Another area of focus is the role of keratinocytes, a type of skin cell, in triggering and sustaining psoriasis. Studies suggest that various factors like genetics, cytokines, and metabolism influence keratinocyte function, possibly linking them to the disease. Understanding these factors could lead to targeted treatments for psoriasis. Resources like ClinicalTrials.gov and the National Psoriasis Foundation can help people find relevant clinical trials. This ongoing research aims to deepen understanding of psoriasis and improve treatment options, targeting various aspects of the disease.

Reference: Fletcher J. Research update: The latest psoriasis treatments and studies. Medical News Today. Updated February 10, 2023. Accessed March 28, 2024. https://www.medicalnewstoday.com/articles/psoriasis-treatments-and-studies-update

A treatment guide analyzed biologics, injectable medications made from living cells that specifically target parts of the immune system, and their treatment efficacy for psoriasis. Four classes of biologics are currently available for treating psoriasis: TNF-alpha blockers, IL-12/23 inhibitors, IL-17 inhibitors, and IL-23 inhibitors. Each class works by blocking different immune system messengers and varies in dosing regimen and side effects.

Candidates for biologics typically have moderate to severe psoriasis, though the treatment may also be considered for cases with significant impact on smaller skin areas. People with active cancer, untreated infections, or generally poor health should avoid biologics. Side effects may include increased risk of infections and malignancies, and for IL-17 blockers, a heightened risk of inflammatory bowel disease. Despite these risks, biologics are considered safe with regular dermatological follow-up and blood monitoring. Most biologics are self-injectable using auto-injector pens for convenience. While not a permanent cure, biologics can offer long-term, effective management of psoriasis symptoms.

Reference: Zeichner J. Treatment guide: Biologics for psoriasis. Medical News Today. Updated March 19, 2024. Accessed March 28, 2024. https://www.medicalnewstoday.com/articles/biologics-for-psoriasis

Psoriasis, a chronic skin condition, profoundly impacts patients' quality of life, encompassing psychological, emotional, and physical aspects. Traditional clinician-reported outcomes (CROs) often fail to capture the full extent of patients' experiences, as they do not align closely with patient-reported outcome measures (PROMs). To address this gap, a study aimed to assess the complementary value of PROMs alongside CROs in routine psoriasis treatment. Analyzing data from over 1700 patients, the study found discrepancies between CROs and PROMs in assessing disease severity and determining the need for systemic therapy initiation. Notably, PROMs identified a significant number of patients who met therapy initiation criteria missed by CROs.

The study underscores the potential of PROMs as essential indicators in dermatological care, providing valuable insights into patients' experiences beyond what CROs offer. Routine collection of both CROs and PROMs could enhance shared decision-making between patients and clinicians, particularly when discrepancies arise in severity assessments. 

Reference: Barbieri JS, Gelfand JM. Patient-Reported Outcome Measures as Complementary Information to Clinician-Reported Outcome Measures in Patients With Psoriasis. JAMA Dermatol. 2021 Oct 1;157(10):1236-1237. doi: 10.1001/jamadermatol.2021.3341. PMID: 34495286; PMCID: PMC8427484.

This article systematically reviews patient-reported outcome (PRO) measures developed and validated for assessing the impact of psoriasis on physical, social, and psychological functioning. Through a comprehensive search of databases like PubMed, PsycINFO, and CINAHL, 45 PRO measures were identified, with 16 specific to psoriasis. Notably, no single PRO measure was found to adequately capture the full impact of psoriasis on patient well-being, highlighting the need for a valid, sensitive, and specific PRO measure to guide comprehensive clinical management. The review emphasizes the importance of PRO measures in guiding treatment decisions by assessing various aspects of patients' well-being. Despite the identification of numerous PRO measures, the lack of evidence for their validity, reliability, and sensitivity to change poses challenges in their clinical utility. Moving forward, there is a pressing need for the development of a PRO measure that encompasses the multidimensional impact of psoriasis on patient well-being to facilitate more comprehensive clinical management strategies.

Reference: Kitchen H, Cordingley L, Young H, Griffiths CE, Bundy C. Patient-reported outcome measures in psoriasis: the good, the bad and the missing! Br J Dermatol. 2015;172(5):1210-21. doi: 10.1111/bjd.13691. Epub 2015 Apr 12. PMID: 25677764.

Two 12-week phase 3 pivotal trials evaluated the efficacy and tolerability of Tapinarof cream 1% once daily in adults with mild-to-severe plaque psoriasis, demonstrating significant efficacy compared to the vehicle. Patients completing the 12-week treatment were eligible for 40 weeks of open-label tapinarof based on their Physician Global Assessment score in PSOARING 3, with a 4-week follow-up period. Among the 763 eligible patients enrolled, 78.5% completed the Patient Satisfaction Questionnaire, revealing that most patients experienced continued and durable improvements in health-related quality of life, with high rates of satisfaction and positive perceptions of tapinarof cream, as indicated by Dermatology Life Quality Index scores and responses to the Patient Satisfaction Questionnaire.

These results underscore the potential benefits of tapinarof cream 1% once daily in managing psoriasis symptoms and highlight the importance of patient-reported outcomes in assessing treatment efficacy and satisfaction.

Reference: Bagel J, Gold LS, Del Rosso J, et al. Tapinarof cream 1% once daily for the treatment of plaque psoriasis: Patient-reported outcomes from the PSOARING 3 trial. J Am Acad Dermatol. 2023 Nov;89(5):936-944. doi: 10.1016/j.jaad.2023.04.061. Epub 2023 May 10. PMID: 37172733.

A multicenter retrospective study in Italy evaluated the effectiveness of bimekizumab, a monoclonal antibody targeting Interleukin-17 A and F, in patients with moderate-to-severe plaque psoriasis. Conducted across 19 referral hospitals, the study included 237 patients treated with bimekizumab over a one-year period. Results showed significant improvement in psoriasis area and severity index (PASI) scores, with 43.3% of patients achieving complete skin clearance at week 4 and 75.4% at week 16. Importantly, 86.8% of patients reported no negative impact on their quality of life by week 16, and adverse events were generally mild, with oral candidiasis being the most common.

The study suggests that bimekizumab is effective and well-tolerated in real-world settings, aligning with findings from phase-III clinical trials. These results underscore the potential of bimekizumab as a valuable treatment option for patients with moderate-to-severe plaque psoriasis, highlighting its role in improving both skin symptoms and quality of life.

Reference: Gargiulo L, Narcisi A, Ibba L, et al. Effectiveness and safety of bimekizumab for the treatment of plaque psoriasis: a real-life multicenter study-IL PSO (Italian landscape psoriasis). Front Med (Lausanne). 2023 Aug 8;10:1243843. doi: 10.3389/fmed.2023.1243843. PMID: 37614958; PMCID: PMC10442506.

Psoriasis often involves joint symptoms known as psoriatic arthritis (PsA) in about 20% of cases. Effective treatments must target both skin and joint symptoms. While biologic therapies have been a breakthrough for unresponsive cases, Janus Kinase inhibitors (JAKis) have recently emerged as promising oral treatments. This review analyzed randomized-controlled trials (RCTs) of JAKis approved by the European Medicines Agency and FDA for plaque psoriasis and PsA to understand their effects on psoriasis.

The review found that three JAKis— tofacitinib, upadacitinib, and deucravacitinib—showed efficacy in treating psoriasis and PsA. Tofacitinib significantly improved both skin and joint symptoms in several phase 2 and 3 RCTs. Deucravacitinib, with its TYK2 selectivity, proved effective with a favorable safety profile. Upadacitinib, tested in two phase 3 RCTs, improved PsA symptoms and showed potential for skin treatment. JAKis provide a new treatment option for psoriasis, especially for patients with concurrent PsA, by effectively managing inflammation and improving quality of life.

Reference: Furtunescu AR, Georgescu SR, Tampa M, Matei C. Inhibition of the JAK-STAT Pathway in the Treatment of Psoriasis: A Review of the Literature. Int J Mol Sci. 2024;25(9):4681. doi: 10.3390/ijms25094681. 

The review offers a detailed examination of biosimilars, akin to biologics but more affordable, elucidating their intricate manufacturing and regulatory approval processes. It also delves into the distinctions between biologics, biosimilars, and generics, highlighting the complexities of biosimilar development and the necessity for stringent quality control. Additionally, it provides a comprehensive roster of EMA-approved biosimilar medicines for dermatological conditions, emphasizing their cost-saving potential and enhanced accessibility to advanced healthcare.

Furthermore, the review anticipates the future direction of biosimilars, discussing the advent of "biobetters" aimed at refining therapeutic profiles through structural enhancements. It concludes by addressing the ongoing discourse on biosimilars, recognizing their transformative impact on healthcare and advocating for continued research and innovation to meet the needs of patients with serious ailments.

Reference: Constantin MM, Cristea CM, Taranu T, et al. Biosimilars in dermatology: The wind of change. Exp Ther Med. 2019;18(2):911-915. doi: 10.3892/etm.2019.7505.

Psoriasis treatments for patients of all ages often include topicals, phototherapy, oral agents like methotrexate and cyclosporine, new oral inhibitors, and biologic injectables. However, older patients, especially those with moderate-to-severe psoriasis, face higher risks of side effects from systemic treatments, such as methotrexate, due to factors like reduced renal function and common comorbidities. Adjusting doses based on true kidney function, which may be overestimated in older adults with low creatinine levels, is critical.

When choosing treatments, comorbid conditions should guide decisions. For example, cyclosporine may not be suitable for patients with hypertension, while anti-TNF agents may help those with a history of heart attacks. Older patients with extensive psoriasis may require systemic agents or phototherapy, and insurance coverage plays a key role in accessing biologics, especially for those on Medicare. While phototherapy use has decreased, it remains effective. The challenges of treating psoriasis in aging patients highlight the need for continued research to ensure the safety and efficacy of new medications for this population.

Reference: Lebwohl M. Psoriasis in Older Patients: Key Considerations and Best Practices for Effective Management. International Psoriasis Council. Accessed September 12, 2024. https://psoriasiscouncil.org/expert-insights/psoriasis-in-older-patients-effective-management/

In recent decades, our understanding of psoriasis has shifted from viewing it as solely a hyperproliferative skin condition to recognizing its immune-mediated origins. The discovery of cytokine pathways, particularly IL-23's role in activating the Th17 pathway, has led to the development of targeted biologic therapies that specifically inhibit cytokines like IL-17 and TNF-α. This approach represents a significant advancement over older, less targeted treatments, enhancing both efficacy and safety by minimizing broad immunosuppression, thereby transforming the management of moderate-to-severe psoriasis.

The psoriasis treatment landscape has expanded significantly with over 13 FDA-approved biologics and novel topical and oral therapies. Ongoing research into biomarkers and personalized medicine aims to refine treatment strategies and address challenges like nail psoriasis and treatment accessibility, ensuring continuous innovation in psoriasis care.

Reference: Brownstone N. Psoriasis Therapies in 2024 and Beyond. Dermatology Times. Published January 16, 2024. Accessed June 18, 2024. https://www.dermatologytimes.com/view/psoriasis-therapies-in-2024-and-beyond

Researchers of a recent study examined psoriasis in special body areas, such as the scalp, palmoplantar, genitals, and nails. The researchers analyzed data from 346 patients and found that 81.6% had involvement in two or more of these special areas, with severity increasing as more areas were affected. Notably, patients with genital psoriasis had an increased likelihood of having scalp and palmoplantar involvement. The study also found that patients with special area psoriasis typically had moderate to severe disease, with many experiencing a significant impact on their quality of life, especially those with genital involvement.

The study revealed that treatment approaches varied depending on the number of affected areas, with biologics being more commonly prescribed for patients with two or more special areas involved. Topicals and traditional medications were more often used for single-area cases. The findings highlight the interconnectedness of psoriasis in different body regions. Researchers suggest more research is needed on effective treatment strategies for patients with area-specific psoriasis, especially as the use of biologics appears to increase with the involvement of multiple special areas.

Reference: Hebebrand M. Interconnections of Psoriasis in Special Body Areas. Dermatology Times. Published July 18, 2024. Accessed September 12, 2024. https://www.dermatologytimes.com/view/interconnections-of-psoriasis-in-special-body-areas

Researchers of the LITE Study demonstrated that home-based phototherapy for psoriasis is non-inferior to office-based phototherapy across all skin types and significantly improves treatment adherence. The study, which enrolled 783 participants, showed that patients using home-based devices received more treatments and achieved better skin clearance compared to those receiving office-based phototherapy. Additionally, more than half of the home-based group reported a minimal impact on their health-related quality of life. This suggests that home phototherapy could be a viable and more accessible option for patients, potentially overcoming barriers like frequent office visits and high copays.

The LITE Study's findings are significant as they offer new insights into the effectiveness and safety of home phototherapy, addressing the critical need for more accessible treatment options for patients with psoriasis. Researchers hope these results will encourage healthcare providers, patients, payers, and policymakers to consider home-based phototherapy as a standard care option, ultimately improving access to this treatment. The study highlights the importance of patient-centered research and the potential to enhance clinical practice by integrating treatment options that align with patients' lifestyles and needs.

Reference: Onorati H. At-Home Phototherapy Betters Treatment Adherence. National Psoriasis Foundation. Published May 29, 2024. Accessed August 16, 2024. https://www.psoriasis.org/advance/at-home-phototherapy-betters-treatment-adherence/

Psoriasis is a chronic, immune-mediated inflammatory skin disease affecting around 125 million people worldwide, especially in Western countries. It is characterized by hyperproliferative keratinocytes and immune cell infiltration, often involving both skin and joints. The IL-23/IL-17 axis drives disease pathogenesis, with environmental triggers in genetically predisposed individuals initiating a cascade of immune responses. Diagnosis relies on clinical evaluation, dermoscopy, and tools like PASI and BSA scores, with advanced imaging and biomarker-based methods emerging. Key risk factors include genetic predisposition, metabolic conditions, infections, and environmental exposures, all contributing to significant physical and psychological burden.

Mesenchymal stem cells (MSCs) and their exosomes (MSC-Exo) show promise as treatments due to their strong immunomodulatory and anti-inflammatory effects. Preclinical studies demonstrate that MSCs inhibit inflammatory pathways, modulate T-cell responses, and reduce keratinocyte proliferation. MSC-Exo offer similar benefits with fewer safety concerns. In vivo studies confirm their ability to suppress IL-17/IL-23 signaling and restore immune balance. Clinical trials report symptom relief and long-term remission with both MSC and exosome therapies, pointing toward exosome-based, cell-free approaches as a safer and potentially more effective direction for psoriasis treatment.

Reference: Dairov A, Sekenova A, Alimbek S, et al. Psoriasis: The Versatility of Mesenchymal Stem Cell and Exosome Therapies. Biomolecules. 2024 Oct 24;14(11):1351. doi: 10.3390/biom14111351. PMID: 39595528; PMCID: PMC11591958.