OR skin psoriasis is a chronic inflammatory disease that affects millions of people worldwide. It is a disorder where the immune system causes skin cells to multiply faster than normal, resulting in the formation of psoriatic plaques, which are sometimes painful and itchy, red and scaly. Although there is no definitive cure, treatment options have evolved rapidly, giving patients hope for long-term remission and improved quality of life.

Local Treatments

Topical treatments are the first line of defense for mild to moderate psoriasis. Ointments and creams are applied directly to the psoriatic lesions to reduce inflammation, redness and peeling. Often used **corticosteroids**, which are strong anti-inflammatory, and **vitamin D** analogues, which regulate the growth of skin cells. **Calcineurin inhibitors** are also popular topical treatments, with a different mechanism of action but a common goal of reducing inflammation. These are used in special places where the disease can manifest itself.

Despite their effectiveness, topical treatments are usually only sufficient for milder forms of the disease and may cause irritation or side effects with prolonged use, especially if they are strong corticosteroids.

Phototherapy

**phototherapy** is a classic but effective treatment option for moderate to severe psoriasis. **UVB radiation** is mainly used, which limits the rapid proliferation of skin cells. This method requires frequent visits to specialized centers and comes with minor risks, such as photoaging or an increased risk of skin cancer. However, phototherapy can be combined with other treatments for better results and often leads to prolonged remission.

Systematic Treatments

In cases of severe psoriasis, when local treatments and phototherapy do not work, **systemic treatments** are applied. These drugs are taken by mouth or by injection.

The best known drugs in this class are **methotrexate**, **cyclosporine** and **acitretin**. Although effective, they can have side effects such as hepatotoxicity, hypertension, and disturbances in kidney function. Because of these risks, their use is closely monitored by doctors and only applied when other treatments have failed.

Biological Treatments

The most recent advances in the treatment of psoriasis have led to the development of **biologics**, which target specific immune system pathways involved in psoriasis. Biological drugs are based on monoclonal antibodies and offer great precision in treatment. They target specific inflammatory factors, such as **TNF-α** and **interleukins IL-17, IL-12/23**.

These drugs have revolutionized the treatment of severe psoriasis, providing significant symptom relief in many patients and often leading to long-term remission. Biological treatments are generally safer than traditional systemic treatments, require specialist monitoring, and are expensive.

New Developments and Research

In addition to the treatments already available, researchers continue to look at new approaches to combat psoriasis. **Gene therapy** is an area of ​​great interest, aimed at understanding the genetic factors that contribute to the onset of disease. Research is also focusing on the role of the skin’s **microbiome**, as it has been found that imbalances in the microbes living on the skin can contribute to inflammation.

At the same time, new drugs targeting different molecular mechanisms are under clinical trials, offering hope for even more effective and safe treatments.

Conclusions

The treatment of cutaneous psoriasis has made significant progress in recent years, offering a wide range of options, from topical treatments and phototherapy, to systemic and biologic therapies. As treatments become more individualized, patients can achieve better control of their symptoms and improve their quality of life.

Future research is expected to lead to even more targeted and innovative treatments that offer greater safety and efficacy, potentially bringing us closer to a definitive cure for this chronic and often debilitating disease.