The therapeutic potential of natural products for pediatric psoriasis: targeting the immune microenvironment

Psoriasis is a chronic, recurrent, inflammatory skin disorder closely associated with dysregulation of the immune microenvironment. Conventional systemic therapies often face limitations in children due to safety concerns, highlighting the urgent need for safer and effective treatment options. Natural products, characterized by their multi-target and multi-pathway actions along with relatively favorable safety profiles, as suggested primarily by adult and preclinical studies, have shown great potential in modulating the immune microenvironment. This review summarizes recent advances in the use of natural products-including plant extracts, active components, and compound formulations-in reshaping the immune microenvironment of psoriatic lesions by regulating T cell subsets, cytokine networks, innate immune cell functions, and skin barrier integrity. We explicitly distinguish between evidence derived from pediatric clinical studies, adult studies, and preclinical models. Furthermore, the article explores the implications of these findings for developing novel therapeutic strategies specifically tailored for pediatric psoriasis, addressing current challenges, and outlining future directions for translational research. By integrating these insights, this review aims to provide a comprehensive understanding of how natural products can contribute to safer and more effective immunomodulatory treatments in children with psoriasis.