Integrating clinical challenges and nanotechnological based approaches for psoriasis therapy

Psoriasis is a chronic, inflammatory, immune-mediated, papulosquamous skin disease with diverse clinical phenotypes. It is frequently associated with cardiometabolic and rheumatologic comorbidities, as well as significant physical and psychological impact, accounting for the fourth largest global burden of disability. Conventional topical and systemic drug therapies constitute the basis of therapeutic protocols; however, their efficacy in alleviating the symptoms, decrease recurrence or resolving inflammation is limited by predominantly single-target mechanisms and pharmacokinetic challenges imposed by extra- and intracellular barriers. In this review, we discuss recent breakthroughs in understanding psoriasis's pathological targets and immunopathogenic mechanisms. Simultaneously, several materials with multifunctional properties have emerged, constituting innovative drug delivery systems, such as nanoparticles and microneedles, specifically designed to improve topical drug delivery, allow precise targeting within the lesion and combination therapies. We highlight the importance of the design and composition of these formulations to improve therapeutic efficacy and their evolution in the administration of various agents, from conventional drugs and natural compounds to therapeutic nucleic acids. To place these advances in a broader context, we integrate recent insights into immunopathogenesis and clinical heterogeneity with material-driven design, demonstrating how nanosystems and microneedles can complement conventional therapies and support the application of emerging multi-targeted approaches. The innovations discussed here open new avenues for optimizing treatment satisfaction and highlight the potential of nanotechnology-driven strategies to revolutionize psoriasis treatment. However, challenges remain in translating these technologies into clinical practice.