ADVANCEMENTS AND CHALLENGES IN PSORIASIS MANAGEMENT: EXPLORING INNOVATIVE THERAPIES, DRUG DELIVERY SYSTEMS, AND HOLISTIC APPROACHES

Authors

  • TANVINDER KOUR Department of Pharmaceutics, St. Soldier Institute of Pharmacy, Lidhran Campus, Behind NIT (R. E. C), Jalandhar–Amritsar Bypass, NH-1, Jalandhar–144011, Punjab, India
  • AJEETPAL SINGH Department of Pharmacology, St. Soldier Institute of Pharmacy, Lidhran Campus, Behind NIT (R. E. C), Jalandhar–Amritsar Bypass, NH-1, Jalandhar–144011, Punjab, India
  • AMAR PAL SINGH Department of Pharmacology, St. Soldier Institute of Pharmacy, Lidhran Campus, Behind NIT (R. E. C), Jalandhar–Amritsar Bypass, NH-1, Jalandhar–144011, Punjab, India

DOI:

https://doi.org/10.22159/ijcpr.2026v18i2.7057

Keywords:

Psoriasis management, Innovative therapies, Drug delivery systems, Holistic approaches, Treatment advancements, Clinical challenges

Abstract

The fast proliferation of skin cells that results in the production of red, scaly plaques-most frequently on the scalp, elbows, knees, and lower back-is the hallmark of psoriasis, a chronic, non-contagious skin illness. Psoriasis is generally acknowledged to be a complex illness involving immune system dysregulation and genetic predisposition; even if it’s precise origin is still unknown. Its development and exacerbation are also significantly influenced by environmental triggers, trauma, stress, and climatic circumstances. Itching, discomfort, dry skin, joint inflammation (psoriatic arthritis), and irregular nail growth are some of the clinical manifestations of psoriasis. Patients' physical, mental, social, and financial quality of life is greatly impacted by the illness, which frequently results in stigmatization, depression, and diminished capacity for day-to-day functioning. Although there are many therapeutic options available, there is no permanent cure, hence the main goals of illness management are symptom control and quality of life enhancement. Given the mounting evidence that psoriasis is a systemic inflammatory disease, understanding its comorbidities-such as diabetes and cardiovascular disease-is essential to provide patients with complete care. Biological therapies, phototherapy, non-biological systemic medications, and topical medicines are all used in modern treatment plans. Systemic and biologic medicines are essential for treating severe psoriasis, but topical therapies are the main choice for mild to moderate instances. These traditional treatments, however, are constrained by side effects, exorbitant expenses, and inconsistent patient reactions. Promising substitutes to improve therapeutic results are provided by the development of nano-carrier drug delivery systems, such as liposomes, phytosomes, niosomes, ethosomes, and transferosomes. These vesicular systems provide targeted, sustained drug release, improved bioavailability, and reduced systemic toxicity. Continued exploration and clinical validation of these innovative delivery platforms are crucial to overcoming the shortcomings of existing therapies and improving patient quality of life in psoriasis care.

Downloads

Download data is not yet available.

References

1. Mahbubur Rahman Y, Manveen Kaur A, Omveer Singh. A review on psoriasis. Neuro Quanology. 2022;20(16):5786-93. doi: 10.48047/NQ.2022.20.16.NQ880588.

2. Raharja A, Mahil SK, Barker JN. Psoriasis: a brief overview. Clinical Medicine (London, England). 2021 May;21(3):170–3. doi: 10.7861/clinmed.2021-0257.

3. Dand N, Mahil SK, Capon F, Smith CH, Simpson MA, Barker JN. Psoriasis and genetics. Acta Derm Venereol. 2020;100(3):adv00030. doi: 10.2340/00015555-3384, PMID 31971603.

4. Singh S, Prasad R, Tripathi JS, Rai NP. Psoriasis-an overview. World Journal of Pharmaceutical Sciences. 2015;3(8):1732–40.

5. Augustin M, Langenbruch A, Gutknecht M, Reich K, Korber A, Maaßen D. Definition of psoriasis severity in routine clinical care: current guidelines fail to capture the complexity of long-term psoriasis management. Br J Dermatol. 2018;179(6):1385-91. doi: 10.1111/bjd.17128, PMID 30334253.

6. Menaa F. Recent highlights and expert opinion on psoriasis management. Journal of Dermatology Research. 2020;1(1):1–4. doi: 10.46889/JDR.2020.1102.

7. Shahwan KT, Kimball AB. Psoriasis and cardiovascular disease. Medical Clinics of North America. 2015 Nov;99(6):1227-42. doi: 10.1016/j.mcna.2015.08.001.

8. Owczarczyk Saczonek AB, Nowicki RJ. Prevalence of cardiovascular disease risk factors and metabolic syndrome and its components in patients with psoriasis aged 30 to 49 y. Postepy Dermatologii i Alergologii. 2015;32(4):290–5. doi: 10.5114/pdia.2014.40966.

9. Boehncke S, Thaci D, Beschmann H, Ludwig RJ, Ackermann H, Badenhoop K. Psoriasis patients show signs of insulin resistance. Br J Dermatol. 2007 Dec;157(6):1249-51. doi: 10.1111/j.1365-2133.2007.08190.x, PMID 17916217.

10. Perk J, De Backer G, Gohlke H, Graham I, Reiner Z, Verschuren WM. European guidelines on cardiovascular disease prevention in clinical practice (version 2012) the fifth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Eur Heart J. 2012 Jul;33(13):1635-701. doi: 10.1093/eurheartj/ehs092.

11. Nazeer M, Ravindran S, Gangadharan G, Criton S. A survey of treatment practices in management of psoriasis patients among dermatologists of Kerala. Indian Dermatol Online J. 2019;10(4):437-40. doi: 10.4103/idoj.IDOJ_306_18, PMID 31334065.

12. Medically reviewed by Joan Paul. MD: MPH, DTMH, Dermatology-Written By Adam Felman Updated on; 2024 Jan 8.

13. Langley RG, Krueger GG, Griffiths CE. 3Psoriasis: epidemiology clinical features and quality of life. Ann Rheum Dis. 2005;64(Suppl 2):ii18-23. doi: 10.1136/ard.2004.033217, PMID 15708928.

14. Farber EM, Nall LM. The natural history of psoriasis in 5600 patients. Dermatological. 1974;148(1):1-18. doi: 10.1159/000251595.

15. World Health Organization. Global report on psoriasis. Geneva: World Health Organization; 2016. Available from: https://www.who.int/publications/i/item/9789241565189.

16. Boehncke WH. Systemic inflammation and cardiovascular comorbidity in psoriasis patients: causes and consequences. Front Immunol. 2018 Apr;9(9):579. doi: 10.3389/fimmu.2018.00579, PMID 29675020.

17. Alexis AF, Blackcloud P. Psoriasis in skin of color: epidemiology, genetics, clinical presentation and treatment nuances. J Clin Aesthet Dermatol. 2014;7(11):16-24. PMID 25489378.

18. Gottlieb A, Korman NJ, Gordon KB, Feldman SR, Lebwohl M, Koo JY. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 2 psoriatic arthritis: overview and guidelines of care for treatment with an emphasis on the biologics. J Am Acad Dermatol. 2008 May;58(5):851-64. doi: 10.1016/j.jaad.2008.02.040, PMID 18423261.

19. Van De Kerkhof PC, Schalkwijk J. Psoriasis. In: Bolognia JL, Jorizzo JL, Rapini RP, editors. Dermatology. 2nd ed. St Louis: Mosby/Elsevier; 2008. p. 115.

20. Naldi L, Peli L, Parazzini F, Carrel CF. Family history of psoriasis stressful life events and recent infectious disease are risk factors for a first episode of acute guttate psoriasis: results of a case-control study. J Am Acad Dermatol. 2001 Mar;44(3):433-8. doi: 10.1067/mjd.2001.110876, PMID 11209111.

21. Abel EA, Di Cicco LM, Orenberg EK, Fraki JE, Farber EM. Drugs in exacerbation of psoriasis. J Am Acad Dermatol. 1986 Nov;15(5 Pt 1):1007-22. doi: 10.1016/S0190-9622(86)70265-X, PMID 2878015.

22. Gupta MA, Gupta AK, Kirkby S, Schork NJ, Gorr SK, Ellis CN. A psychocutaneous profile of psoriasis patients who are stress reactors: a study of 127 patients. Gen Hosp Psychiatry. 1989 May;11(3):166-73. doi: 10.1016/0163-8343(89)90036-4, PMID 2721939.

23. Higgins E. Alcohol smoking and psoriasis. Clin Exp Dermatol. 2000;25(2):107-10. doi: 10.1046/j.1365-2230.2000.00588.x, PMID 10733631.

24. Naldi L, Peli L, Parazzini F. Association of early-stage psoriasis with smoking and male alcohol consumption: evidence from an Italian case-control study. Arch Dermatol. 1999;135(12):1479-84. doi: 10.1001/archderm.135.12.1479, PMID 10606053.

25. Chaudhury S, Das AL, John RT, Ramadasan P. Psychological factors in psoriasis. Indian J Psychiatry. 1998 Jul;40(3):295-9. PMID 21494487.

26. Armstrong AW, Read C. Pathophysiology, clinical presentation and treatment of psoriasis: a review. JAMA. 2020;323(19):1945-60. doi: 10.1001/jama.2020.4006, PMID 32427307.

27. Menter A, Korman NJ, Elmets CA, Feldman SR, Gelfand JM, Gordon KB. Guidelines of care for the management of psoriasis and psoriatic arthritis: section 4. Guidelines of care for the management and treatment of psoriasis with traditional systemic agents. J Am Acad Dermatol. 2009 Sep;61(3):451-85. doi: 10.1016/j.jaad.2009.03.027, PMID 19493586.

28. National Psoriasis Foundation. About psoriasis: clinical presentation and symptoms. National Psoriasis Foundation; 2023. Available from: https://www.psoriasis.org.

29. Mease PJ. Psoriatic arthritis: update on pathophysiology assessment and management. J Rheumatol. 2009;36(Suppl 83):3-8.

30. Finlay AY, Coles EC. The effect of severe psoriasis on the quality of life of 369 patients. Br J Dermatol. 1995;132(2):236-44. doi: 10.1111/j.1365-2133.1995.tb05019.x, PMID 7888360.

31. Krueger G, Koo J, Lebwohl M, Menter A, Stern RS, Rolstad T. The impact of psoriasis on quality of life: results of a 1998 national psoriasis foundation patient-membership survey. Arch Dermatol. 2001 Mar;137(3):280-4. PMID 11255325.

32. Fortune DG, Richards HL, Griffiths CE, Main CJ. Psychological stress, distress and disability in patients with psoriasis: consensus and variation in the contribution of illness perceptions, coping and alexithymia. Br J Clin Psychol. 2002;41(2):157-74. doi: 10.1348/014466502163949, PMID 12034003.

33. Bhosle MJ, Kulkarni A, Feldman SR, Balkrishnan R. Quality of life in patients with psoriasis. Health Qual Life Outcomes. 2006;4:35. doi: 10.1186/1477-7525-4-35.

34. Choi J, Koo JY. Quality of life issues in psoriasis. J Am Acad Dermatol. 2003 Aug;49(2 Suppl):S57-61. doi: 10.1016/S0190-9622(03)01136-8, PMID 12894127.

35. Horn EJ, Fox KM, Patel V, Chiou CF, Dann F, Lebwohl M. Association of patient-reported psoriasis severity with income and employment. J Am Acad Dermatol. 2007;57(6):963-71. doi: 10.1016/j.jaad.2007.07.023, PMID 17761358.

36. Bakshi H, Nagpal M, Singh M, Dhingra GA, Aggarwal G. Treatment of psoriasis: a comprehensive review of entire therapies. Curr Drug Saf. 2020;15(2):82-104. doi: 10.2174/1574886315666200128095958, PMID 31994468.

37. Torsekar R, Gautam MM. Topical therapies in psoriasis. Indian Dermatol Online J. 2017 Jul-Aug;8(4):235-45. doi: 10.4103/2229-5178.209622, PMID 28761838.

38. Bernhard J, Whitmore C, Guzzo C, Kantor I, Kalb RE, Ellis C. Evaluation of halobetasol propionate ointment in the treatment of plaque psoriasis: report on two double-blind, vehicle-controlled studies. J Am Acad Dermatol. 1991 Dec;25(6 Pt 2):1170-4. doi: 10.1016/0190-9622(91)70320-2, PMID 1757612.

39. Cather JC, Abramovits W, Menter A. Cyclosporine and tacrolimus in dermatology. Dermatol Clin. 2001;19(1):119-37. doi: 10.1016/S0733-8635(05)70234-5, PMID 11155577.

40. Binderup L, Bramm E. Effects of a novel vitamin D analogue MC903 on cell proliferation and differentiation in vitro and on calcium metabolism in vivo. Biochem Pharmacol. 1988;37(5):889-95. doi: 10.1016/0006-2952(88)90177-3, PMID 2830885.

41. Kalb RE, Strober B, Weinstein G, Lebwohl M. Methotrexate and psoriasis: 2009 national psoriasis foundation consensus conference. J Am Acad Dermatol. 2009;60(5):824-37. doi: 10.1016/j.jaad.2008.11.906, PMID 19389524.

42. Collins P, Rogers S. The efficacy of methotrexate in psoriasis a review of 40 cases. Clin Exp Dermatol. 1992;17(4):257-60. doi: 10.1111/j.1365-2230.1992.tb02161.x, PMID 1451315.

43. Salvarani C, Boiardi L, Macchioni P, Pipitone N, Catanoso M, Pigatto P. Multidisciplinary focus on cyclosporin a. J Rheumatol Suppl. 2009;83:52-5. doi: 10.3899/jrheum.090225, PMID 19661542.

44. Di Caprio R, Caiazzo G, Cacciapuoti S, Fabbrocini G, Scala E, Balato A. Safety concerns with current treatments for psoriasis in the elderly. Expert Opin Drug Saf. 2020;19(4):523-31. doi: 10.1080/14740338.2020.1728253, PMID 32056449.

45. Dogra S, Yadav S. Acitretin in psoriasis: an evolving scenario. Int J Dermatol. 2014;53(5):525-38. doi: 10.1111/ijd.12365, PMID 24601982.

46. Papp K, Reich K, Leonardi CL, Kircik L, Chimenti S, Langley RG. Apremilast an oral phosphodiesterase 4(PDE4) inhibitor, in patients with moderate to severe plaque psoriasis: results of a phase III, randomized controlled trial (efficacy and safety trial evaluating the effects of apremilast in psoriasis [esteem] 1). J Am Acad Dermatol. 2015 Jul;73(1):37-49. doi: 10.1016/j.jaad.2015.03.049, PMID 26089047.

47. Balak DM. Fumaric acid esters in the management of psoriasis. Psoriasis (Auckl). 2015;5:9-23. doi: 10.2147/PTT.S51490, PMID 29387578.

48. Pedraz J, Dauden E, Delgado Jimenez Y, Garcia Rio I, Garcia Diez A. Sequential study on the treatment of moderate-to-severe chronic plaque psoriasis with mycophenolate mofetil and cyclosporin. J Eur Acad Dermatol Venereol. 2006;20(6):702-6. doi: 10.1111/j.1468-3083.2006.01577.x, PMID 16836499.

49. Wong T, Hsu L, Liao W. Phototherapy in psoriasis: a review of mechanisms of action. J Cutan Med Surg. 2013;17(1):6-12. doi: 10.2310/7750.2012.11124, PMID 23364144.

50. Feldman SR, Goffe B, Rice G, Mitchell M, Kaur M, Robertson D. The challenge of managing psoriasis: unmet medical needs and stakeholder perspectives. Am Health Drug Benefits. 2016 Dec;9(9):504-13. PMID 28465778.

51. Pandey R, Bhairam M, Shukla SS, Gidwani B. Colloidal and vesicular delivery system for herbal bioactive constituents. Daru. 2021;29(2):415-38. doi: 10.1007/s40199-021-00403-x, PMID 34327650.

52. Nakhaei P, Margiana R, Bokov DO, Abdelbasset WK, Jadidi Kouhbanani MA, Varma RS. Liposomes: structure, biomedical applications and stability parameters with emphasis on cholesterol. Front Bioeng Biotechnol. 2021 Sep 9;9:705886. doi: 10.3389/fbioe.2021.705886, PMID 34568298.

53. Alharbi WS, Almughem FA, Almehmady AM, Jarallah SJ, Alsharif WK, Alzahrani NM. Phytosomes as an emerging nanotechnology platform for the topical delivery of bioactive phytochemicals. Pharmaceutics. 2021 Sep 15;13(9):1475. doi: 10.3390/pharmaceutics13091475, PMID 34575551.

54. Lu M, Qiu Q, Luo X, Liu X, Sun J, Wang C. Phyto-phospholipid complexes (phytosomes): a novel strategy to improve the bioavailability of active constituents. Asian J Pharm Sci. 2019 May;14(3):265-74. doi: 10.1016/j.ajps.2018.05.011, PMID 32104457, PMCID PMC7032241.

55. Kazi KM, Mandal AS, Biswas N, Guha A, Chatterjee S, Behera M. Niosome: a future of targeted drug delivery systems. J Adv Pharm Technol Res. 2010 Oct;1(4):374-80. doi: 10.4103/0110-5558.76435, PMID 22247876.

56. Ge X, Wei M, He S, Yuan WE. Advances of non-ionic surfactant vesicles (niosomes) and their application in drug delivery. Pharmaceutics. 2019;11(2):55. doi: 10.3390/pharmaceutics11020055, PMID 30700021.

57. Abdulbaqi IM, Darwis Y, Khan NA, Assi RA, Khan AA. Ethosomal nanocarriers: the impact of constituents and formulation techniques on ethosomal properties in vivo studies and clinical trials. Int J Nanomedicine. 2016;11:2279-304. doi: 10.2147/IJN.S105016, PMID 27307730.

58. Van Meer G, Voelker DR, Feigenson GW. Membrane lipids: where they are and how they behave. Nat Rev Mol Cell Biol. 2008;9(2):112-24. doi: 10.1038/nrm2330, PMID 18216768.

59. Umar H, Wahab HA, Gazzali AM, Tahir H, Ahmad W. Cubosomes: design, development and tumor-targeted drug delivery applications. Polymers (Basel). 2022;14(15):3118. doi: 10.3390/polym14153118, PMID 35956633.

60. Gonzalez RO, Higa LH, Cutrullis RA, Bilen M, Morelli I, Roncaglia DI. Archaeosomes made of halorubrum tebenquichense total polar lipids: a new source of adjuvancy. BMC Biotechnol. 2009 Aug 13;9:71. doi: 10.1186/1472-6750-9-71, PMID 19678953.

61. Babaie S, Bakhshayesh AR, Ha JW, Hamishehkar H, Kim KH. Invasome: a novel nanocarrier for transdermal drug delivery. Nanomaterials (Basel). 2020;10(2):341. doi: 10.3390/nano10020341, PMID 32079276.

62. Cevc G. Material transport across permeability barriers by means of lipid vesicles. In: Lipowsky R, editor. Handbook of Physics of Biological Systems. Biological Physics. Amsterdam: Elsevier Science; 1994. p. 441–66.

63. Cevc G, Blume G, Schatzlein A, Gebauer D, Paul A. The skin: a pathway for systemic treatment with patches and lipid-based agent carriers. Adv Drug Deliv Rev. 1996;18(3):349-78. doi: 10.1016/0169-409X(95)00091-K.

Published

15-03-2026

How to Cite

KOUR, TANVINDER, et al. “ADVANCEMENTS AND CHALLENGES IN PSORIASIS MANAGEMENT: EXPLORING INNOVATIVE THERAPIES, DRUG DELIVERY SYSTEMS, AND HOLISTIC APPROACHES”. International Journal of Current Pharmaceutical Research, vol. 18, no. 2, Mar. 2026, pp. 1-8, doi:10.22159/ijcpr.2026v18i2.7057.

Issue

Section

Review Article(s)

Most read articles by the same author(s)

<< < 1 2 3 4 > >>