Psoriasis as a systemic inflammatory disease: an immune set-point framework for comorbidities and relapse

Area of Science:

• Immunology
• Dermatology
• Systemic Inflammation

Background:

• Psoriasis is recognized as a systemic immune-mediated disorder beyond skin inflammation.
• Growing evidence links psoriasis to immune homeostasis disruption and sustained systemic inflammation.

Purpose of the Study:

• To review the systemic immune mechanisms underlying psoriasis.
• To propose psoriasis as a maladaptive reprogramming of the systemic immune set-point.

Main Methods:

• Review of current scientific literature on psoriasis.
• Analysis of immunologic mechanisms, including immune activation, myeloid programming, and immunometabolism.

Main Results:

• Psoriasis involves persistent immune activation, altered myeloid programming, and dysregulated immunometabolic pathways.
• This creates chronic inflammatory priming contributing to multi-organ comorbidities and disease relapse.
• Durable immune memory and trained immunity play a role in disease recurrence.

Conclusions:

• Psoriasis reflects a maladaptive reprogramming of the systemic immune set-point.
• Shared immunologic mechanisms drive both multi-organ involvement and disease recurrence.
• This perspective impacts comorbidity assessment, maintenance strategies, and disease modification pursuits.