Research in the pathogenesis of inflammatory skin diseases, such as skin dermatitis and psoriasis, has seen advancements in recent years. The understanding of age-related factors, gender, and genetic predisposition of these multifactorial diseases has helped in developing new pharmacological and technological treatment approaches. 

There are different grades of psoriasis, which can be measured by different Indexes like the Psoriasis Area and Severity Index (PASI), which is the most accurate. The PASI permits comparisons between clinical trials and objectively evaluates the effectiveness of different antipsoriatic drugs. These criteria categorized psoriasis in various grades ranging from mild to moderate to severe psoriasis. Mild to moderate psoriasis (accounting for about 80% of the cases) can be treated with topical treatments. Moderate cases may utilize some topical treatments, based on corticosteroids, used in combination with other drugs, like vitamin D, or alone, such as vitamin D derivatives, vitamin A, and anthralin. Severe cases may demand a systemic treatment, sometimes combined with local treatment, due to the increased extension of the affected surface. 

The therapeutic results of the topical treatments can be enhanced by using some adjunct agents, like penetrating or permeating enhancers, or phototherapy. Furthermore, the treatment adherence can be improved by a combination regime, as it allows applications in a fixed dose with a low frequency of application.

Conventional drugs still remain the backbone of the treatment of psoriasis. However emerging efforts have led to the development of drugs and biosimilars with improved therapeutic outcomes, with fewer side effects and higher effectiveness. New approaches, such as nanoparticles which comes in a wide range with particular advantage and limitation, have been proposed to encourage new treatments. Nanoparticles based on a polymeric matrix provides a controlled release of the loaded drug and improved permeation rates, but have limited drug loading capacity and difficulties in scaling up the production lines. Lipid-based nanoparticles may offer higher load capacity and encapsulation efficiency, especially for poorly water-soluble drugs, and are biocompatible and may even act as absorption/penetration enhancers, due to their lipid composition. Microneedles eliminate the challenges associated with conventional therapies like adverse-side effects, low bioavailability, or non-specificity in oral-systemic treatments. Additionally, they improve permeation and increase specificity more than conventional topical treatments of different skin disorders. Although only one type of microneedle has been applied in psoriasis treatment (dissolving microneedles), their results are really promising. These novel technologies open a window to different perspectives to obtain innovative and effective treatments against psoriasis.

Source- Therapeutics. Int J Mol Sci. 2021;22(9):4983. Published 2021 May 7. doi:10.3390/ijms22094983