Phytotherapeutics and Novel Approaches towards Treatment of Psoriasis – A Systematic Review

Secukinumab is effective in the treatment of recalcitrant palmoplantar psoriasis and palmoplantar pustular psoriasis in a daily practice setting

Treatment of psoriasis vulgaris using low-dose naltrexone

Successful use of secukinumab in pustular psoriasis

Recalcitrant psoriasis responding to new bilogic drug: Ustekinumab

Viewing Psoriasis as a Systemic Disease for Better Health Outcomes

IL-17C is a member of the IL-17 family of cytokines. The expression of IL-17C has been demonstrated to be strongly induced by TNFα in human keratinocytes, and recently the level of IL-17C was found to be increased in the inflammatory skin disease psoriasis. However, little is known about the molecular mechanisms involved in the regulation of IL-17C. Here, we show that pretreatment of cultured human keratinocytes with the inhibitor of κB kinase 2 inhibitor, SC-514, resulted in a significant reduction in both IL-17C mRNA and protein expression, indicating the significance of this pathway in the regulation of IL-17C. NF-κB binding sites were identified upstream from the IL-17C gene, and by electrophoretic mobility shift assay NF-κB was shown to bind to all three identified binding sites. Moreover, NF-κB binding to these sites was inducible by TNFα. Supershift analysis revealed binding of the NF-κB subunits p65 and p50 to all three NF-κB binding sites. To determine the contribution of NF-κB in IL-17C expression, we conducted luciferase gene reporter experiments and demonstrated that a 3204-bp promoter fragment of IL-17C containing three putative NF-κB binding sites was strongly activated by TNFα. Interestingly, mutations of the three NF-κB binding sites revealed that one specific NF-κB binding site was crucial for the TNFα-mediated IL-17C induction because mutation of this specific site completely abolished TNFα-induced IL-17C promoter activation. We conclude that the activation of NF-κB (p65/p50) is crucial for the TNFα-induced stimulation of IL-17C expression in human keratinocytes.

Fungal Infections Complicating Tumor Necrosis Factor α Blockade Therapy

Dual biologic therapy for recalcitrant psoriasis and psoriatic arthritis

Association of Skin Barrier Genes within the PSORS4 Locus Is Enriched in Singaporean Chinese with Early-Onset Psoriasis

New-onset autoantibody-mediated nephritis during ustekinumab therapy for psoriasis in patients with and without prior systemic lupus erythematosus

Calcipotriene ointment 0.005% (Dovonex), marketed by Westwood Squibb Pharmaceuticals, has recently been approved by the United States Food and Drug Administration for the treatment of moderate plaque psoriasis. Calcipotriene, also called calcipotriol or MC 903, is a structural analogue of 1,25-dihydroxyvitamin D3 and is recognized with equal affinity by the 1,25-dihydroxyvitamin D3 receptor. However, calcipotriene's effects on calcium metabolism are 100 times less potent than those of vitamin D.1 In the mid-1980s it was found that 1,25-dihydroxyvitamin D3 inhibited the proliferation of fibroblasts in culture.2 Around the same time, a patient being treated with 1-alphahydroxyvitamin D3 for osteoporosis was reported to show dramatic improvement in her psoriasis.3 Soon after, several investigators reported the use of 1,25-dihydroxyvitamin D3 and a variety of analogues for the treatment of psoriasis. Several placebo-controlled, randomized, double-blind trials have found calcipotriene ointment to be effective, rapidly acting, and safe in the treatment of psoriasis.4,5,6 The drug is more …

The preponderance of evidence supports an aryl hydrocarbon receptor-dependent mechanism of action of tapinarof

Introduction A number of highly selective biologic therapies that target specific immunological pathways of psoriasis have emerged, including molecules that target interleukin (IL)-17. IL-17 has been identified as a key effector pathogenic cytokine in psoriasis, and validated as a highly effective therapeutic target for the treatment of plaque psoriasis. Area covered This review examines the therapeutic efficacy and safety of IL-17 inhibitors in plaque psoriasis and provides an overview of the efficacy and safety data of brodalumab compared with other IL-17 inhibitors. Expert opinion In the real world, the treatment of psoriasis has been revolutionized by the new class of drugs belonging to IL-17 inhibitors, with secukinumab, ixekizumab, and brodalumab currently licensed and approved for the treatment of moderate-to-severe plaque psoriasis. With its distinct mechanism of action, brodalumab may offer a unique advantage over other IL-17 inhibitors due to its rapid onset of action, achievement of complete skin clearance in a high proportion of patients, and its overall favorable safety profile. Importantly, treatment with systemic biologic drugs should be established early on in the course of the disease in order to prevent comorbidities and to allow patients to achieve a stable and persistent remission.

α-MSH-Stimulated Tolerogenic Dendritic Cells Induce Functional Regulatory T Cells and Ameliorate Ongoing Skin Inflammation

Background: Psoriasis is a very common skin condition that is caused by an immune system problem. T-cells, dendritic cells, macrophages and neutrophils all play a role in the proliferation of keratinocytes. Several genetic and environmental factors are involved in the development of this condition. Objectives: The purpose of this study is to review aetiopathogenic causes and therapeutic aspects of psoriasis. Therefore, the literature review aims to address the following: Explore psoriasis theories and factors that influence psoriasis. Review of effectiveness of different treatment methods in the management of mild, moderate and severe psoriasis. In addition, there is a need to identify and evaluate new or novel therapies in the treatment of moderate and severe forms of psoriasis. Methods: A narrative literature review provides an overview of the extensive literature on the etiology, pathogenesis and treatment of psoriasis. The data comes from well reads articles published over the last 30 years (1992-2022). Electronic databases were taken from Google Scholar, PubMed, Medscape and the University of South Wales. Results: Two hundred two articles, which varied between literature reviews, systematic reviews, review articles, randomized controlled studies, meta-analyses and comparative studies. 100 out of 202 of the articles in this thesis focused on discussing the etiology, pathogenesis, pathophysiology and psoriasis treatments. Conclusion: Psoriasis is a multifactorial chronic disease. Genetics, immune and environmental factors play a significant role in its development. Psoriasis is a treatable but incurable disease that is widespread and has a significant impact on quality of life. Advances in understanding the etiology and pathogenesis of psoriasis will undoubtedly lead to the discovery of new treatments and better patient outcomes and improve quality of life for patients.