Ancient and advanced approaches for the treatment of an inflammatory autoimmune disease-psoriasis

Psoriasis is a chronic, proliferative, and inflammatory skin disease with reactive abnormal epidermal differentiation and hyperproliferation that affects 2-3% of the global population. Various types of psoriasis have been identified by clinical outcomes such as skin biopsies and blood analysis: plaque psoriasis, flexural psoriasis, guttate psoriasis, pustular psoriasis, psoriatic arthritis, scalp psoriasis, nail psoriasis, and erythrodermic psoriasis. The major factors which may be considered as causes of psoriasis are bacterial infections or other infection triggers, genetics, environment, immune disorders, weather, stress triggers, and skin injury. Various ancient approaches such as acupuncture, water treatment, and dietary treatment are available to help control psoriasis, but they are only able to relieve symptoms. Currently, numerous advanced strategies are based on the type of psoriasis, its location, extent, and severity. Nanotechnological approaches, biological approaches, photodynamic therapy, and PUVA (psoralens + UVA) therapy have been successfully used induce a reduction of psoriasis for months to years. These well-tolerated therapies, which have long-lasting remission and improve quality of life, are effective in 80-85% of patients. In this review, we describe different ancient therapies and advanced approaches to treating moderate-to-severe psoriasis that are on the market or currently in clinical trials.