Antipsoriatic Drug Research Articles

Analytical Methods for the Determination of Anti-Psoriatic Drugs - A Review

Analytical Methods for the Determination of Anti-Psoriatic Drugs - A Review

Rehmannia radix extract ameliorates imiquimod-induced psoriasis-like skin inflammation in a mouse model via the janus-kinase signal transducer and activator of transcription pathway

Background: Rehmannia glutinosa, commonly known as Dihuang, is a medicinal herb widely used in the formulations of traditional Chinese medicine. Radix or the root of Rehmannia is a vital ingredient used in various oriental medicines such as Jihwangeumja, Saenghyeoryunbuem, and Gyeongokgo. Hence, in the present study, we evaluated the potency of Rehmannia radix (RR) extract to ameliorate psoriasis like in vivo model induced by imiquimod (IMQ). Materials and Methods: Histopathological and histomorphometrical analysis was performed to assess the effect on RR extract against the psoriasis induction. To estimate whether the RR extract pretreatment inhibits the induction of psoriasis, the oxidative stress and antioxidants status were assessed. Further, to prove ameliorative effect of RR extract against psoriasis induction, the levels of inflammatory cytokines were estimated. Immunoblotting analyses of Janus kinase/signal transducer and activator of transcription (JAK/STAT) protein were estimated to confirm the molecular mechanism of RR extract against psoriasis induction. Results: RR extract effectively scavenged the free radicals, increased the antioxidant status, and decreased the inflammatory cytokines induced by IMQ. It also inhibits the expression of phosphorylated JAK/STAT protein, thereby preventing the dermis from inflammation. Histological analysis of psoriasis-induced and RR-pretreated mice' skin tissue authentically proves the inhibitory effect of RR extract against psoriasis induction. Conclusion: Our overall results suggest that RR extracts possess antipsoriatic property and can be subjected to human trial in the future as antipsoriatic drug.

Pustular Psoriasis: The Dawn of a New Era.

Pustular psoriasis is a clinically heterogeneous entity of different, orphan disease subtypes, among which the most clearly defined are generalized pustular psoriasis, palmoplantar psoriasis, and acrodermatitis continua of Hallopeau. Although phenotypically and genetically distinct from psoriasis vulgaris, these subtypes may be associated with plaque psoriasis lesions, establishing the rationale for their inclusion in the psoriasis spectrum. Unlike psoriasis, however, their genetic background is thought to be mainly monogenic, as shown by the recent identification of mutations in 3 different genes of the skin innate immune system; IL36RN, CARD14 and AP1S3. These major advances in the understanding of the disease pathogenesis have led to the design and ongoing development of tailored therapeutic approaches, which are highly necessary given the refractory nature of pustular psoriasis in response to most available antipsoriatic drugs.

Thymoquinone-loaded lipid vesicles: a promising nanomedicine for psoriasis

BackgroundPsoriasis, a recurrent, chronic inflammatory disorder of skin, is a common problem in middle age and elderly people. Thymoquinone (TQ), a lipid soluble benzoquinone is the major active ingredient of volatile oil of Nigella sativa (NS), possesses good anti-psoriatic activity. However, its hydrophobicity, poor aqueous solubility, and photosensitive nature obstructs its development. Therefore, in the present research work, ethosomal vesicles (EVs) loaded with TQ were assessed for its anti-psoriatic potential employing mouse-tail model.MethodsTQ-loaded EVs were prepared by cold method, and characterized for various essential attributes, viz. particle size, morphology, percent drug entrapment, flexibility, rheological and textural analysis, and skin absorption. The optimized formulation was finally evaluated for anti-psoriatic activity on Swiss albino mice employing mouse-tail model for psoriasis.ResultsThe spherical shaped vesicles were in the nanosize range, and had high flexibility. The EVs incorporated hydrogel was rheologically acceptable and resulted in substantial TQ retention in the skin layers. The % anti-psoriatic drug activity was observed to be substantially better in the case of TQ-loaded ethosomal gel vis-à-vis plain TQ, NS extract, and marketed formulation.ConclusionsThe promising outcomes of the current studies ratify the superiority of TQ-loaded phospholipid-based vesicular systems for the management of psoriasis over other studied test formulations. This study, thus open promising avenues for topical application of TQ in the form of EV hydrogel.

UV synchrotron radiation linear dichroism spectroscopy of the anti-psoriatic drug anthralin

Anthralin (1,8-dihydroxyanthrone, 1,8-dihydroxy-9(10H)-anthracenone), also known as dithranol and cignolin, is one of the most efficient drugs in the treatment of psoriasis and other skin diseases. The precise mode of biochemical action is not fully understood, but the activity of the drug is increased by the influence of UV radiation. In the present investigation, the UV absorption of anthralin is studied by synchrotron radiation linear dichroism (SRLD) spectroscopy on molecular samples partially aligned in stretched polyethylene, covering the near and vacuum UV regions with wavenumbers ranging from 23,000 to 58,000 cm–1(430–170 nm). The observed polarization spectra are well predicted by quantum chemical calculations using time-dependent density functional theory (TD–DFT). About a dozen spectral features are assigned to computed electronic transitions. The calculations support interpretation of the anomalous fluorescence of anthralin as a result of barrier-less excited state intramolecular proton transfer (ESIPT) to the tautomer 8,9-dihydroxy-1(10H)-anthracenone.

Psoriasis in Patients With Active Lung Cancer: Is Apremilast a Safe Option?

Concomitant cancers in psoriasis patients often pose significant limitations in treatment decision. In contrast to the majority of the available systemic antipsoriatic drugs, apremilast is not contraindicated in case of previous or concomitant malignancy [1]. We report a patient with psoriasis and lung adenocarcinoma who completely responded to apremilast. The patient provided written informed consent for the data reported in the current manuscript.

Characteristics and prevalence of plaque psoriasis in patients with palmoplantar pustulosis.

Palmoplantar pustulosis (PPP) is a chronic pustular skin condition on the palms and soles. The disease is often seen in combination with plaque psoriasis, and whether PPP is a variant of psoriasis has been debated. The disease prevalence of PPP and co-occurring psoriasis is not yet established and the patient group remains understudied. To estimate the prevalence of PPP and co-occurring psoriasis in three population-based cohorts and to provide information on patient demographics and characteristics. Administrative healthcare registries and insurance databases from the U.S.A., Denmark and Germany were used as data sources. Patients with PPP were defined by a single International Classification of Diseases 10th Revision code for PPP during a 1-year period. Information regarding co-occurring plaque psoriasis and other comorbidities was extracted. Furthermore, use of antipsoriatic medication was identified. In total 1435, 751 and 1832 patients with PPP were identified in the U.S., Danish and German populations, with estimated 1-year prevalences of 0·009%, 0·005% and 0·08%, respectively. Plaque psoriasis was present in 14·2-61·3% of patients with PPP. Patients with co-occurring psoriasis had an overall higher prevalence of psoriatic arthritis. Similarly, medication use was more prevalent in patients with PPP with co-occurring psoriasis, and especially pronounced was the use of biologic therapies. This large observational study on patients with PPP provides detailed information regarding patient demographics, comorbidities and medication use. The 1-year prevalence of PPP varied in the three studied populations, possibly due to differences in diagnostics and recording practices. Psoriasis frequently co-occurred in patients with PPP. What's already known about this topic? Palmoplantar pustulosis (PPP) is a skin disease of the palms of the hands and soles of the feet and is known to be related to psoriasis. Whether PPP is a distinct disease or a variant of psoriasis is not yet established. The condition is understudied in terms of disease prevalence, disease predictors, patient characteristics and comorbidity. What does this study add? In this study using data from three large population-based cohorts we found low prevalence rates (< 0·1%) of PPP. The prevalence of psoriasis was estimated at between 14·2% and 61·3% in patients with psoriasis. Patients with PPP with co-occurring psoriasis have a higher prevalence of psoriatic arthritis and use of antipsoriatic drugs.

A recent review on Nanoemulsion as a topical delivery system of antipsoriatic drugs

A recent review on Nanoemulsion as a topical delivery system of antipsoriatic drugs

Cyto/chemokine profile of in vitro scratched keratinocyte model: Implications of significant upregulation of CCL20, CXCL8 and IL36G in Koebner phenomenon

BackgroundScratch injury induces Koebner phenomenon in psoriasis. Smoking is also a risk factor for psoriasis. Keratinocytes can produce various psoriasis-related molecules including TNF, IL1 A, IL1B, IL6, IL12B, IL17C, IL23 A, IL36 A, IL36B, IL36 G, CXCL1, CXCL2, CXCL8, CXCL9, CXCL10, CCL20, IFNB, and CAMP. However, the scratch-induced molecular profiling remains elusive. ObjectiveTo profile the induction pattern of above-mentioned psoriasis-related and keratinocyte-derived molecules by scratch injury in the presence or absence of anti-psoriatic drugs or benzo[a]pyrene, a major environmental pollutant of tobacco smoke. MethodsConfluent normal human keratinocytes were scratched and molecules were assayed by qRT-PCR, ELISA and Western blotting with or without drugs and benzo[a]pyrene. ResultsAmong the 18 molecules, the scratch injury on a confluent keratinocyte sheet significantly and selectively upregulated the mRNA expression of four cyto/chemokines, CXCL8, CCL20, IL36G, and TNF, in a scratch-line-number-dependent manner under either low- or high-calcium condition. However, significant protein secretion was only demonstrated for CXCL8 and CCL20. The IL36 G protein was not secreted, but its intracellular level was significantly upregulated by scratch injury, whereas neither the secretion nor the intracellular level of TNF protein was affected by scratch injury. Dexamethasone, but not maxacalcitol nor the phosphodiesterase 4 inhibitor apremilast, partially inhibited the CXCL8 and CCL20 secretion. Benzo[a]pyrene significantly and synergistically enhanced the scratch-induced CCL20 secretion that may explain why smoking is a risk factor for psoriasis. ConclusionCCL20 and to a less extent CXCL8 may play a key role in triggering the Koebner phenomenon after scratch injury to keratinocytes.

Novel Topical Nanocarriers for Treatment of Psoriasis: An Overview.

Psoriasis is an autoimmune disease of the skin with lapsing episodes of hyperkeratosis, irritation and inflammation. Numerous methodologies and utilization of different antipsoriatic drugs with various activity methods and routes of administration have been investigated to treat this terrifying sickness. In any case, till date, there is no remedy for psoriasis because of the absence of an ideal carrier for effective and safe delivery of antipsoriatic drugs. Among the different methods of medications for psoriasis, in the greater part of patients, topical treatment is most commonly utilized. For topical formulations, utilization of conventional excipients could fill the need just to a restricted degree. With the revelation of more up to date biocompatible and biodegradable materials like phospholipids, and Novel drug delivery technologies like liposomes, solid lipid nanoparticles (SLNs), microemulsions, and nanoemulsions, the possibility to enhance the efficiency and safety of the topical products has expanded to a great extent. Understanding the topical delivery aspects and that of outlining and creating different carrier systems have been enhanced that got further novelty to this approach. Present review is an attempt to contemplate on psoriasis as far as improved comprehension of the dermal delivery perspectives and at present accessible treatment alternatives, significant preventions in psoriasis treatment, late advancements in the conveyance of different antipsoriatic drugs through novel colloidal drug transporters.

Use of topical corticosteroids among Danish patients with psoriasis

Psoriasis is a common chronic inflammatory skin disease, affecting about 2‐4% of the population in Europe. Psoriasis negatively affects patients’ quality of life and is linked to several psoriasis‐associated comorbidities (diseases that occur alongside psoriasis). Topical drugs, which means they are applied directly to the skin, are a recommended first‐line treatment for mild‐to‐moderate psoriasis, but their reported real‐life use is conflicting. This study investigated psoriasis patients’ real‐life use of topical drugs and other antipsoriatic treatments. Danish researchers conducted a drug utilization study based on the nationwide Danish health registry data, including data on all patients above 18 years of age who received a first‐time hospital diagnosis of psoriasis and were prescribed at least one topical drug in the period 2005‐2015 (7,743 patients). The patients were followed for a three‐year period after the time of diagnosis. Among many findings, the authors reported that the most frequently used topical antipsoriatic drugs were combinations containing corticosteroid with calcipotriol, accounting for 31% of the total use. Patients’ use of topical drugs increased around the time of hospital diagnosis. The use also varied considerably between geographical regions as well as for the individual patients, with 25% of the patients using 70% of the total amount of topical treatment. The total use of topical antipsoriatic drugs decreased by 19% during the study period, while use of a drug called methotrexate which is taken by tablet or injection, increased by 70%. The authors concluded that the use of topical antipsoriatic drugs shows considerable diversity over time, regional practices and differences between patients.

Effectiveness and safety of secukinumab for psoriasis in real-world practice: analysis of subgroups stratified by prior biologic failure or reimbursement.

Background:Little is known about the treatment outcomes of secukinumab in clinical practice, which differ from those in clinical trials. The effectiveness of biologics may differ in psoriasis patients with previous biologics exposure. The objective of this study was to investigate the real-world effectiveness and safety of secukinumab therapy and analyze subgroups stratified by reimbursement or prior biologic failure.Methods:This retrospective multicenter study collected data from a cohort of 118 consecutive patients who received secukinumab treatment between December 2015 and March 2018. Effectiveness was evaluated by degree of improvement in the Psoriasis Area and Severity Index (PASI) scores. Adverse events and reasons for discontinuation were also recorded.Results:The mean PASI improvement rate at weeks 4, 12, 24, and 36 was 63.5%, 77.7%, 78.7%, and 76.0%, respectively. Compared with reimbursed patients, nonreimbursed patients had a significantly lower baseline PASI and a shorter mean disease duration of psoriasis; they were more frequently biologic-naïve, had used less prior traditional antipsoriatic drugs and were more likely to be treated with secukinumab 150 mg. The effectiveness of secukinumab in nonreimbursed patients was superior despite higher discontinuation rates. Compared with patients without prior biologic failure, patients with prior biologic failure had a significantly lower mean PASI improvement at weeks 12, 24, 36, and 48. The decline in response rates to secukinumab tended to be more pronounced for patients who failed ustekinumab than tumor necrosis factor-α inhibitors. Moreover, the number of prior biologic failures was associated with a decreased response rate and increased likelihood of secondary loss of effectiveness of secukinumab therapy.Conclusion:In a real-life clinical setting, the characteristics of nonreimbursed patients receiving secukinumab treatment differed from those of reimbursed patients. The PASI improvement for secukinumab was substantial but lower than that in clinical trials. The number and classes of prior biologic failures impact the treatment response to secukinumab.

Synthetic analogs of vitamin D3 in therapy of psoriasis

Psoriasis is one of the most common skin diseases and occurs in 1-2% of the population of developed countries. The problem of pathogenetic treatment of psoriasis remains relevant despite the annual appearance of new drugs. The anti-keratinizing effect is particularly important in the treatment of psoriasis. The effect is based on suppression of the proliferation of epidermal keratinocytes, normalization of the differentiation of the nonkeratinizing epithelium and the decrease in the adhesion of horny cells. The last decade is characterized by a deepening of ideas about the biological properties and mechanism of action of vitamin D3. However the vitamin D3 does itself not have therapeutic activity. In this connection the use of synthetic analogues of vitamin D3 which have therapeutic activity is particular of importance.&#x0D; The aim. To evaluate the effectiveness of vitamin D3synthetic analogs for the treatment of psoriasis.&#x0D; Methods. It was retrospective analysis of multicentric studies by a double-blind, randomized method of the effectiveness of vitamin D3 analogs for the treatment of psoriasis in Russia and foreign clinics. The PASI index in assessing the clinical manifestations of psoriasis.&#x0D; Rеsults and discussion. The study of the clinical efficacy of oral forms of the vitamin indicates a positive therapeutic effect in 70-90% of patients but this requires an average of 2.8 months. Therefore for the treatment of psoriasis more widely used synthetic analogue of vitamin D3 – calcipotriol (MS-903), developed exclusively for topical application. Calcipotriol gives minimal side effects and has an intense antipsoriatic effect. The mechanism of action of calcipotriol is based on interaction with specific receptors on keratinocytes which causes inhibition of proliferation, accelerates the morphological differentiation of psoriatic cells, inhibits the activity of interleukin-1 and reduces interleukin-2 production, i.e. has an effect on the pathogenetic mechanisms of psoriasis.&#x0D; Conclusion. Vitamin D3 analogues are effective antipsoriatic drugs that can be used both as monotherapy and in the complex treatment of patients with severe psoriasis.

Rutaecarpine inhibited imiquimod-induced psoriasis-like dermatitis via inhibiting the NF-κB and TLR7 pathways in mice

Psoriasis is a chronic, immune-mediated inflammatory skin disease. As psoriasis rarely occurs in nonhuman animals, the lack of an ideal animal model reflecting the histopathological and molecular immunological characteristics of psoriasis remains an urgent issue. In the present study, an imiquimod-induced psoriasis-like dermatitis mouse model was constructed under natural immune conditions and verified by evaluations of the Psoriasis Area and Severity Index (PASI) score and Baker score, H&E staining, immunohistochemical examination of the CD3 and Gr1 levels, measurement of plasmacytoid dendritic cell- (pDC) and Th17-associated cytokine levels, and evaluation of p65 phosphorylation and TLR7 expression. Moreover, rutaecarpine (RUT), the main active ingredient in the traditional Chinese medicine Wu-Zhu-Yu, could improve psoriasis-like dermatitis through effects on pDC- and Th17-associated cytokines through NF-κB and toll-like receptor 7 (TLR7) signaling. Taken together, the imiquimod-induced psoriasis-like dermatitis mouse model can be regarded as an ideal model for evaluating psoriasis pathogenesis and antipsoriatic drugs. We provided theoretical and experimental evidence for the clinical application of RUT in psoriasis.

Design of an Algorithm for Automated, Computer-Guided PASI Measurements by Digital Image Analysis

The Psoriasis Area and Severity Index (PASI) is the most accepted method for psoriasis severity scoring. However, a prominent level of subjectivity and a low intra- and inter-rater reproducibility was reported. Therefore, an accurate and reproducible measure of psoriasis severity is needed, especially in the setting of registration studies for systemic anti-psoriatic drugs. Herein we describe a robust, user-friendly, computer-guided technology that allows for automated PASI measurements after total body imaging and digital image analysis. For this purpose, a novel image processing software for PASI calculations was developed, which was combined with a commercially available, automated image capturing system. Our data shows, that the software was able to accurately calculate the proportion of psoriatic skin surface as well as the severity of erythema, induration, and desquamation by anatomic region. In a pilot clinical validation the time-efficient technology showed a high reproducibility and high levels of agreement to results attained by PASI-trained physicians. Therefore, automated computer-guided PASI measurements hold the promise of significantly reducing the physicians' workload while ensuring a high level of reproducibility and standardization.

Nonadherence to Treatment with Topical Calcipotriol/Betamethasone Dipropionate Cutaneous Foam due to a Dog Licking off Psoriasis Scales: A Case Report

Objective: We describe a psoriasis patient who let his dog lick his psoriasis lesions, which resulted in nonadherence to prescribed topical calcipotriol/betamethasone dipropiontae (Cal/BD) cutaneous foam. Methods: The patient’s adherence to (Cal/BD) cutaneous foam was objectively monitored by a chip in the medication dispenser and the patient was subsequently visited at his home to observe the dog’s licking process and obtain clinical photos. Conclusion: Topical antipsoriatic drugs containing corticosteroid/calcipotriol preparations are first-line treatment for mild-to-moderate psoriasis, but adherence rates to topical antipsoriatic drugs are low and a barrier for full efficacy of the treatment. Physicians should be aware that a dog licking off psoriasis scales can lead to nonadherence to topical treatment as well as expose the dog owners and their dogs to a risk of adverse events.

Intestinal microbiota profiling and predicted metabolic dysregulation in psoriasis patients.

The intestinal microbiota has been known to involve in obesity and host immune response. We aimed to investigate the intestinal microbiota and potential genetic function in relation to clinical presentation in psoriasis patients. Faecal microbiota and predicted genetic function inferred from high-throughput 16S ribosomal RNA sequencing were analysed between psoriasis (n=32) and age-, gender- and body mass index (BMI)-matched non-psoriasis subjects (n=64), from a referral medical centre. The correlation between altered microbiota and disease activity, arthritis and systemic anti-psoriatic drugs was also investigated. We observed a distinct faecal microbial community structure in psoriasis patients, with an increased abundance of phylum Firmicutes and decreased abundance of phylum Bacteroidetes, across different subgroup of subjects. Ruminococcus and Megasphaera, of the phylum Firmicutes, were the top-two genera of discriminant abundance in psoriasis. A number of functional genes and metabolic pathways involving bacterial chemotaxis and carbohydrate transport were predicted over-represented, whereas genes related to cobalamin and iron transport were predicted under-represented in faecal microbiota of psoriasis patients. The distinct faecal microbial composition in psoriasis might be associated with altered transport of carbohydrate, cobalamin and iron, as well as chemotaxis.

Structure-based drug designing and identification of Woodfordia fruticosa inhibitors targeted against heat shock protein (HSP70-1) as suppressor for Imiquimod-induced psoriasis like skin inflammation in mice model

Heat shock proteins (HSPs) emerged as a therapeutic target and it was observed that inhibition of HSP70-1 plays a pivotal role in the management of psoriasis. In-silico investigation involving techniques like molecular docking and molecular dynamics (MD) simulation analysis was performed against HSP70-1. Further, anti-psoriatic activity of bioactive immunomodulatory compounds present in ethanolic extract of Woodfordia fruticosa flowers (Wffe) using combination of bioinformatics together with ethnopharmacological approach has been explored in this study. Myricetin (−8.024), Quercetin (−7.368) and Ellagic acid (−7.311) were the top three compounds with minimum energy levels as well as high therapeutic value/ADMET as compared to currently available marketed anti-psoriatic drug Tretinoin (−7.195). ADMET prediction was used to screen ligands for drug-likeness and efficacy. Further, biogenically Woodfordia fruticosa gold nanoparticles (WfAuNPs) were synthesized and characterized by UV–Visible Spectroscopy (UV–vis), Dynamic Light Scattering (DLS), Zeta Potential, X-Ray Diffraction (XRD) and High Resolution Transmission Electron Microscopy (HRTEM) techniques. Synthesized WfAuNPs observed in the size range of 10–20 nm and were used to develop WfAuNPs-Carbopol®934 ointment gel. Subsequently, the therapeutic efficacy of WfAuNPs-Carbopol® 934 was checked against 5% Imiquimod-induced psoriasis like skin inflammation. WfAuNPs-Carbopol® 934 was found to be exerting better therapeutic effect in reducing the mean DAI score (0.63 ± 0.08), serum cytokines (TNF-α, IL-22 and IL-23) levels along with reduced epidermal thickness, parakeratosis and marked decrease in the hyperproliferation of keratinocytes. Results of the study revealed that the WfAuNPs-Carbopol® 934 could be an effective alternative treatment for psoriasis in near future.

Use of topical antipsoriatic drugs in Denmark: a nationwide drug utilization study

The reported real-life use of prescribed topical antipsoriatic drugs is conflicting and based on heterogeneous data sources. To describe the utilization of topical antipsoriatic drugs among patients with psoriasis in Denmark. A drug utilization study was performed based on nationwide Danish health registry data. We identified patients who received a first-time hospital diagnosis of psoriasis and redeemed at least one topical drug prescription in the period 2005-2015 (n=7743). Patients were followed for 3years from the time of diagnosis. Use of topical and systemic antipsoriatic drugs was described, specified by the type of treatment. The total use of topical drugs was divided between corticosteroids with calcipotriol (31%), calcipotriol (6·5%), very potent corticosteroids (24%), potent corticosteroids (30%), moderate corticosteroids (7·2%) and corticosteroids with antimicrobials (1·6%). There was a 19% reduction in the overall use of topical drugs during the study period. Use increased around the time of diagnosis and the majority of patients redeemed more than two packages of topical drugs during the first year after being diagnosed. Regional differences in patients' use of topical drugs varied considerably. The distribution of use of topical drugs was uneven, with a minority of all patients (25%) using 70% of the total amount of topical treatment. There was a 70% increase in the use of methotrexate over the study period. Biologics were used by up to 6%. The study provides further evidence that the use of topical antipsoriatic drugs shows considerable heterogeneity over time and regional practices, and differences between patients.

Role of Angiogenic Growth Factors in Psoriasis: A Review.

Psoriasis is a chronic disease of inflammatory nature. It involves autoimmune mechanism and the systemic diseased state is created by the interaction of immune system, autoantigens and variety of environmental triggers. It is a complex skin disease which involves participation of numerous factors, making it multifactorial in nature. The main characteristics include proliferation of keratinocytes, increase in dermal vascularity and infiltrated immune cells. Among all factors, vascular alterations present a significant feature of the disease and angiogenesis seems to have an important role in giving rise to psoriasis phenotype. In the early phases of psoriasis there occurs sprouting of new blood vessels which disappear with disease clearance. Psoriatic lesions show highly altered vascular network in the form of numerous enlarged, tortuous and hyperpermeable cutaneous blood vessels. Secretion of various pro-angiogenic growth factors promote the expansion of vascular network in psoriatic skin cells. In addition to pro-angiogenic growth factors, pro-inflammatory cytokines also contribute to this process by activating endothelial cells and exerting pro-angiogenic action as well. Angiogenesis, in psoriasis display a close association of vascular endothelium activation, angiogenesis, inflammation and lesional skin, as is demonstrated by in vivo models. The present review discusses angiogenesis as the central process in the evolution of psoriasis and summarizes various angiogenic mediators and their respective roles in the development of psoriasis. Anti-angiogenic therapies targeting vasoproliferation may represent a valid approach for the development of anti-psoriatic drugs and further development in this field can pave way to new fields of treatment. Such therapies could be at par to those directly targeting inflammation.