Psoriasis: implication to disease and therapeutic strategies, with an emphasis on drug delivery approaches

Skin is the most visible and vulnerable organ of the integumentary system. Psoriasis is a chronic inflammatory skin disorder with an equal prevalence rate in males and females globally. Psoriasis is seen today beyond a cosmetic turmoil as it significantly impacts the socioeconomic life of the patients. Patients with severe psoriasis report feeling denounced and isolated. Despite detailed understanding of the molecular mechanisms and pathogenesis of psoriasis, issues like the autoimmune cause of inflammation and role of external, genetic, cutaneous, and systemic factors on initiation, progression, and treatment of psoriasis are still ambiguous. The present review summarizes immunogenic pathophysiology of psoriasis with a cascade of events from stimuli-based release of self-nucleotides to the hyperproliferation of keratinocytes leading to psoriasis. The review emphasizes challenges and hurdles toward the efficient treatment of psoriasis. The review also provides a detailed understanding of conventional and novel treatment strategies including drug delivery approaches and patented technologies for therapeutic and preventive approaches leading to improved outcome for psoriasis patients. The review summarizes a brief insight on biologics and gene therapy that has resulted in a paradigm shift in the treatment strategies for psoriasis management.