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Updated: May 24, 2026

The Goeckerman Regimen for the Treatment of Moderate to Severe Psoriasis
Published on: July 11, 2013
Cytokine-based therapy in psoriasis.
Anupam Mitra1, Robyn S Fallen, Hermenio Cavalcante Lima
1Department of Dermatology, VA Medical Centre, Sacramento, University of California, Davis, Sacramento, CA, USA.
Psoriasis and psoriatic arthritis are autoimmune diseases. Targeting the interleukin-23/T-helper 17 (IL-23/Th17) axis with cytokine antagonists shows promise for treating these conditions.
Area of Science:
- Immunology
- Dermatology
- Rheumatology
Background:
- Psoriasis and psoriatic arthritis are chronic inflammatory autoimmune diseases affecting 2-3% of the global population.
- Initially viewed as keratinocyte disorders, they are now understood to involve the immune system, particularly the interleukin-23/T-helper 17 (IL-23/Th17) axis.
- The focus has shifted from Th1 to Th17 cytokines, specifically IL-17 and IL-22, in disease pathogenesis.
Purpose of the Study:
- To review the central role of specific cytokines in psoriasis pathophysiology.
- To provide a strategic approach to novel therapeutic agents targeting the IL-23/Th17 axis.
- To analyze the efficacy of cytokine antagonists in treating psoriasis and psoriatic arthritis.
Main Methods:
- Literature review of studies on psoriasis and psoriatic arthritis pathophysiology.
- Analysis of the role of the IL-23/Th17 axis and related cytokines (IL-17, IL-22).
- Examination of therapeutic strategies involving cytokine antagonists, including ustekinumab, anti-IL-17A, and anti-IL-22.
Main Results:
- The IL-23/Th17 axis is crucial in the pathophysiology of psoriatic diseases.
- Cytokine antagonists targeting IL-17 and IL-22 have shown efficacy in animal models.
- Ustekinumab, an IL-12/IL-23 inhibitor, demonstrates the therapeutic potential of targeting this axis.
Conclusions:
- Cytokine antagonists represent a significant therapeutic modality for psoriasis and psoriatic arthritis.
- Further research is necessary to validate the efficacy and safety of these agents.
- Targeting the IL-23/Th17 pathway offers a promising strategy for managing psoriatic diseases.