ADVANCED APPROACHES TO THE TREATMENT OF PSORIASIS. LITERATURE REVIEW

Abstract

Introduction: Psoriasis is a chronic inflammatory skin disease. In addition to affecting the skin, the condition is characterized by complications such as joint and nail involvement and is associated with systemic disorders including obesity, hypertension, cardiovascular diseases, and kidney disorders. These comorbidities and symptoms influence treatment choices. Therefore, it is important to find an appropriate therapeutic approach that leads to improvement and, ideally, complete recovery from the disease. Objective: The aim of this literature review is to analyze current methods of psoriasis treatment, with a focus on efficacy, safety, and the potential for personalized therapy. Search Strategy: The literature search was conducted in databases including PubMed, Medline, Embase, and Cochrane. The results were then sorted, screened by title, and irrelevant studies were excluded. The search covered a period of 7 years, from 2018 to 2025. Results: Psoriasis affects at least 60 million people worldwide. Clinically, it presents as red, scaly plaques on the skin, which may appear on various parts of the body and cause significant physical and psychological burden. Moreover, the disease may pose a serious threat to the patient due to its involvement of vital organs and systems, including cardiometabolic disorders, psoriatic arthritis, and depression—all of which negatively impact quality of life. Psoriasis is an immune-mediated inflammatory skin disease. The IL-23/IL-17 axis plays a key role in its pathogenesis. The efficacy of biological therapies such as IL-23 inhibitors (ustekinumab, guselkumab, tildrakizumab, risankizumab) and IL-17 inhibitors (secukinumab, ixekizumab, brodalumab) supports this understanding. In our publication, we describe an approach to managing patients with psoriasis across the entire disease spectrum—from mild to moderate and severe forms—aiming to create a positive healing dynamic and improvement in condition, while ensuring efficacy and safety through personalized treatment tailored to the patient’s needs. Conclusions: In our study, we propose possible approaches to restoring immune homeostasis through a combined, personalized strategy that includes early intervention with biologic agents, advanced therapeutic techniques, and lifestyle modifications.