Therapeutic strategies for psoriasis

Psoriasis is a chronic, inflammatory, hyperproliferative skin disease that affects approximately 1-2% of the general population in the U.K. and U.S.A. It is rarely life-threatening, but causes considerable patient morbidity. The disease waxes and wanes, with substantial variability both between and within individual patients. There is no cure for psoriasis; therefore, the aim of treatment is to minimize the extent and severity of the disease to the point at which it no longer disrupts substantially the patient's quality of life. We review the current treatment options, which include topical therapies, phototherapy and systemic agents. Lack of efficacy, adverse effects and aesthetic problems limit the use of many topical therapies. Likewise, the risk of toxicity is a major problem with currently available phototherapies and systemic treatments. Advances in understanding the aetiology and pathogenesis of psoriasis allude to the possibility of innovative, targeted therapies in the future.