Novel Treatment strategies for Management of Psoriasis: Current update and Future Perspective.

2021 
Psoriasis is an auto-immune disorder of the skin, affects 1-3% of the total population. It has characteristic features such as the enhanced proliferation of keratinocytes, scaling, and increased secretion of inflammatory mediators. Over the last decade, the treatment of psoriasis has advanced considerably. Different treatment strategies consisting of topical, systemic, phototherapy and biologics have been used to treat mild to moderate psoriasis disorder. Commonly topical therapies are favored over systemic therapies to treat mild to moderate psoriatic disease conditions. Systemic approaches include the usage of Immuno-suppressants and biological agents etc. However, none of them are safe and effective enough to treat this infection. Almost all of them suffer from the disadvantage of creating resistance. Recent discoveries in psoriasis pathogenesis are paving the way for new therapeutics to concentrate on molecular level targeting for psoriasis. Various approaches comprising topically to gene therapy using nano carrier-based drug delivery systems have also been used for treatment. Nanocarriers comprise liposomes, ethosomes, solid lipid nanoparticles, nanocapsules, micelles, liposomes, and nanostructured lipid carriers, etc. Nanocarriers as a delivery system have the potential to offer an alternate means of effective and safe treatment of psoriasis. The targeting ability of these nanocarriers at the molecular level has improved the efficacy of therapeutics. An extensive clinical trial for the delivery of small molecules in both topical and systemic therapy is also in progress to provide better treatment strategies. These can improve the efficacy with minimized adverse effects on long-term therapy. For future perspective points, gene therapy might act as a promising treatment approach for psoriasis treatment and its management. It would build a solid foundation for research into the development of precise medication for psoriasis. This review primarily focuses on current therapy and various new future therapeutic strategies for the treatment and management of psoriasis.
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