Abstract
Background: Psoriasis is an autoimmune disease that ingeminates itself with the repeated proliferation of keratinocytes. It globally strikes a 2-5 % population on an average. Management of psoriasis remains a daunting task with various challenges influencing treatment, such as patient conformity and adherence to therapy, delicate patient profiles, psychological aspects, and skin as a barrier to topical delivery. The first part reviewed pathophysiology, triggering factors, and clinical classification. The second part reviewed all the therapies, such as topical, oral, biological, parenteral therapy, phototherapy, and the phyto-pharmaceuticals.
Methods: The research data related to the existing and upcoming therapies for psoriasis treatment, several nanocarriers, existing marketed formulations, and detailed description of phytopharmaceuticals with their mechanism.
Results: Topical therapy is the mainstay treatment option with limited adverse effects. Biological therapy has reformed conventional psoriasis treatment by being more efficacious and has increased patient acceptance due to decreased adverse events. Nanoformulations present an edge over conventional therapy due to improved anti-psoriatic effect and decreased side effects. Phyto-pharmaceuticals act as a complementary and alternative therapy for diminishing psoriasis symptoms.
Conclusion: A rationalized cost-effective patient compliant therapy is required for effective management and complete cure of psoriasis.
Keywords: Topical, nanoformulations, autoimmune, challenges, psychological, symptomatic.
Graphical Abstract
[http://dx.doi.org/10.1016/j.jconrel.2016.07.003] [PMID: 27381248]
[http://dx.doi.org/10.1146/annurev-immunol-032713-120225] [PMID: 24655295]
[http://dx.doi.org/10.1111/bjd.12230] [PMID: 23374051]
[http://dx.doi.org/10.1016/S0190-9622(03)01134-4] [PMID: 12894125]
[http://dx.doi.org/10.1007/s11926-007-0075-1] [PMID: 18177599]
[http://dx.doi.org/10.1016/j.jaci.2017.07.004] [PMID: 28887948]
[http://dx.doi.org/10.12688/f1000research.7927.1] [PMID: 27158469]
[http://dx.doi.org/10.3109/21691401.2014.955105] [PMID: 25229831]
[http://dx.doi.org/10.1038/jid.2015.296] [PMID: 26214380]
[http://dx.doi.org/10.1007/s13671-013-0066-6] [PMID: 25580373]
[http://dx.doi.org/10.1111/bjd.15610] [PMID: 28555722]
[http://dx.doi.org/10.1016/j.clindermatol.2007.08.007] [PMID: 18021890]
[http://dx.doi.org/10.1016/j.jaad.2008.10.062] [PMID: 19231638]
[http://dx.doi.org/10.3109/10837450.2013.763260] [PMID: 23369039]
[http://dx.doi.org/10.1016/j.disamonth.2018.06.001] [PMID: 30037762]
[http://dx.doi.org/10.1016/S0738-081X(97)00024-2] [PMID: 9313966]
[http://dx.doi.org/10.1111/j.1365-2133.1984.tb04678.x] [PMID: 6232938]
[http://dx.doi.org/10.1016/j.jdermsci.2009.02.009] [PMID: 19395243]
[PMID: 23057623]
[http://dx.doi.org/10.1016/S0190-9622(86)70265-X] [PMID: 2878015]
[PMID: 59510]
[http://dx.doi.org/10.1111/j.1365-2133.1977.tb15186.x] [PMID: 921900]
[http://dx.doi.org/10.1016/j.mehy.2009.02.051] [PMID: 19560286]
[http://dx.doi.org/10.1001/archderm.135.12.1479] [PMID: 10606053]
[http://dx.doi.org/10.1111/j.1365-2133.1992.tb14818.x] [PMID: 1637689]
[http://dx.doi.org/10.1016/S0190-9622(97)80394-5] [PMID: 9270550]
[http://dx.doi.org/10.1111/j.1365-2133.1989.tb01338.x] [PMID: 2730848]
[http://dx.doi.org/10.1038/nature05663] [PMID: 17314973]
[http://dx.doi.org/10.1590/abd1806-4841.20142633] [PMID: 24770509]
[http://dx.doi.org/10.1016/j.sder.2008.12.003] [PMID: 19341941]
[http://dx.doi.org/10.1097/QAI.0000000000001431] [PMID: 28692580]
[PMID: 17498423]
[http://dx.doi.org/10.1111/1346-8138.13850] [PMID: 28452173]
[http://dx.doi.org/10.1001/archderm.1997.03890420043005] [PMID: 9197824]
[http://dx.doi.org/10.1016/0140-6736(92)90852-T] [PMID: 1347382]
[http://dx.doi.org/10.1111/j.1365-2133.2010.10180.x] [PMID: 21155753]
[http://dx.doi.org/10.1097/00000372-200410000-00003] [PMID: 15365366]
[http://dx.doi.org/10.1016/j.autrev.2012.10.002] [PMID: 23183378]
[http://dx.doi.org/10.1002/art.37885] [PMID: 23401011]
[http://dx.doi.org/10.1007/s12026-007-8014-9] [PMID: 18172584]
[http://dx.doi.org/10.1136/ard.2005.050377] [PMID: 16793844]
[http://dx.doi.org/10.1136/ard.2011.150995] [PMID: 21803753]
[http://dx.doi.org/10.1111/j.1346-8138.2010.00871.x] [PMID: 20860740]
[http://dx.doi.org/10.1159/000249365] [PMID: 3089849]
[http://dx.doi.org/10.1016/j.clindermatol.2007.08.006] [PMID: 18021889]
[http://dx.doi.org/10.1111/j.1529-8019.2010.01304.x] [PMID: 20415817]
[http://dx.doi.org/10.1111/j.1365-2230.2010.03877.x] [PMID: 20545954]
[http://dx.doi.org/10.1016/j.genhosppsych.2006.12.004] [PMID: 17336662]
[http://dx.doi.org/10.1016/j.bcp.2012.01.001] [PMID: 22257911]
[http://dx.doi.org/10.1586/egh.09.45] [PMID: 19817673]
[http://dx.doi.org/10.1001/archderm.134.5.595] [PMID: 9606329]
[PMID: 23173102]
[http://dx.doi.org/10.1177/120347540400800502] [PMID: 15868312]
[http://dx.doi.org/10.1111/j.1468-3083.2005.01329.x] [PMID: 16274404]
[http://dx.doi.org/10.1111/ijd.12365] [PMID: 24601982]
[http://dx.doi.org/10.1002/art.10712] [PMID: 12528125]
[http://dx.doi.org/10.1007/s10238-013-0252-7] [PMID: 23949337]
[http://dx.doi.org/10.3899/jrheum.090225] [PMID: 19661542]
[http://dx.doi.org/10.1016/j.jaad.2015.03.049] [PMID: 26089047]
[http://dx.doi.org/10.2147/PTT.S51490] [PMID: 29387578]
[http://dx.doi.org/10.1111/j.1468-3083.2006.01577.x] [PMID: 16836499]
[http://dx.doi.org/10.2310/7750.2012.11124] [PMID: 23364144]
[http://dx.doi.org/10.1590/abd1806-4841.20175603] [PMID: 29166504]
[http://dx.doi.org/10.15570/actaapa.2014.7] [PMID: 24964946]
[http://dx.doi.org/10.1001/archderm.144.12.1571] [PMID: 19075139]
[http://dx.doi.org/10.1016/j.arcped.2018.12.005] [PMID: 30638928]
[http://dx.doi.org/10.2147/PHMT.S75834] [PMID: 29388608]
[http://dx.doi.org/10.4049/jimmunol.174.1.164] [PMID: 15611238]
[http://dx.doi.org/10.1016/j.tig.2010.06.006] [PMID: 20692714]
[http://dx.doi.org/10.1001/jamadermatol.2013.5264] [PMID: 23945732]
[http://dx.doi.org/10.1111/j.1610-0387.2012.07919.x] [PMID: 22386073]
[http://dx.doi.org/10.1111/bjd.12039] [PMID: 22963128]
[http://dx.doi.org/10.1159/000329026] [PMID: 21757881]
[http://dx.doi.org/10.1111/dth.12267] [PMID: 26258910]
[http://dx.doi.org/10.1046/j.1365-2230.2001.00834.x] [PMID: 11422186]
[http://dx.doi.org/10.1016/j.jaad.2004.10.862] [PMID: 15761421]
[http://dx.doi.org/10.1001/archderm.140.4.408] [PMID: 15096368]
[http://dx.doi.org/10.1007/s12272-001-1148-8] [PMID: 18365697]
[http://dx.doi.org/10.1021/mp400639e] [PMID: 25057896]
[http://dx.doi.org/10.1016/j.ijpharm.2009.02.010] [PMID: 19429291]
[http://dx.doi.org/10.1016/j.ijpharm.2012.01.045] [PMID: 22310459]
[http://dx.doi.org/10.3109/10717544.2015.1110845] [PMID: 26592918]
[http://dx.doi.org/10.1016/j.ijpharm.2013.08.019] [PMID: 23973754]
[http://dx.doi.org/10.1016/j.colsurfb.2015.02.038] [PMID: 25766924]
[http://dx.doi.org/10.1016/j.ejps.2016.10.025] [PMID: 27777066]
[http://dx.doi.org/10.1016/S0169-409X(02)00118-7] [PMID: 12460720]
[http://dx.doi.org/10.1016/0378-5173(93)90313-5]
[http://dx.doi.org/10.1016/S0939-6411(03)00067-5] [PMID: 12957632]
[http://dx.doi.org/10.1080/17425247.2017.1264386] [PMID: 27882780]
[http://dx.doi.org/10.1016/j.chemphyslip.2014.11.004] [PMID: 25447290]
[http://dx.doi.org/10.1016/j.jconrel.2016.05.017] [PMID: 27170227]
[http://dx.doi.org/10.1016/j.biomaterials.2018.08.030] [PMID: 30142524]
[http://dx.doi.org/10.1016/j.actbio.2019.04.002] [PMID: 30951898]
[http://dx.doi.org/10.1016/j.ijpharm.2010.09.007] [PMID: 20858539]
[http://dx.doi.org/10.1016/j.ijpharm.2014.10.067] [PMID: 25445970]
[http://dx.doi.org/10.1016/j.jddst.2017.07.024]
[http://dx.doi.org/10.1166/jbn.2010.1152] [PMID: 21329048]
[http://dx.doi.org/10.5138/ijaps.2010.0976.1055.01012]]
[http://dx.doi.org/10.7150/thno.29715] [PMID: 30662553]
[http://dx.doi.org/10.1016/j.jconrel.2007.08.005] [PMID: 17884226]
[http://dx.doi.org/10.1208/pt0802028] [PMID: 17622106]
[http://dx.doi.org/10.1016/j.jddst.2018.12.020]
[http://dx.doi.org/10.1016/j.nano.2017.02.009] [PMID: 28259803]
[http://dx.doi.org/10.1016/j.nano.2019.03.017] [PMID: 31004811]
[http://dx.doi.org/10.1186/1477-3155-9-44] [PMID: 21952107]
[http://dx.doi.org/10.1016/j.ijpharm.2015.12.019] [PMID: 26688038]
[http://dx.doi.org/10.1016/j.ijpharm.2016.01.042] [PMID: 26806466]
[http://dx.doi.org/10.1016/j.ejpb.2016.11.018] [PMID: 27867112]
[http://dx.doi.org/10.1016/j.msec.2018.06.049] [PMID: 30184748]
[http://dx.doi.org/10.1016/j.ijpharm.2018.05.053] [PMID: 29800737]
[http://dx.doi.org/10.1016/B978-0-12-816505-8.00010-2]
[http://dx.doi.org/10.1016/S0005-2736(01)00369-8] [PMID: 11557020]
[http://dx.doi.org/10.22159/ijpps.2017v9i8.18571]
[http://dx.doi.org/10.1016/j.nano.2018.05.021] [PMID: 29944981]
[http://dx.doi.org/10.3109/02652048.2012.717115] [PMID: 23088318]
[http://dx.doi.org/10.1016/j.ejps.2017.02.030] [PMID: 28232140]
[http://dx.doi.org/10.1016/j.jconrel.2010.10.005] [PMID: 20950659]
[http://dx.doi.org/10.1016/j.jconrel.2012.06.021] [PMID: 22732474]
[http://dx.doi.org/10.1166/jnn.2016.11670] [PMID: 27433583]
[http://dx.doi.org/10.3109/03639041003598960] [PMID: 20590450]
[http://dx.doi.org/10.1016/j.colsurfb.2017.10.029] [PMID: 29035818]
[http://dx.doi.org/10.1016/j.heliyon.2019.e01343] [PMID: 30957038]
[http://dx.doi.org/10.3109/1061186X.2013.771778] [PMID: 23594093]
[http://dx.doi.org/10.1016/j.jconrel.2016.09.007] [PMID: 27639683]
[http://dx.doi.org/10.1016/j.colsurfb.2017.07.080] [PMID: 28779637]
[http://dx.doi.org/10.4103/2229-5178.120635] [PMID: 24350003]
[http://dx.doi.org/10.3390/molecules21121719] [PMID: 27983701]
[http://dx.doi.org/10.1016/j.colsurfb.2016.01.021] [PMID: 26852097]
[http://dx.doi.org/10.1016/j.jconrel.2017.10.034] [PMID: 29074408]
[http://dx.doi.org/10.1111/exd.13707] [PMID: 29906306]
[http://dx.doi.org/10.1016/j.intimp.2018.09.048] [PMID: 30293051]
[http://dx.doi.org/10.1016/j.phanu.2016.10.002]
[http://dx.doi.org/10.1016/j.cbi.2017.04.020] [PMID: 28450041]
[http://dx.doi.org/10.6227/jfda.2012200311]
[http://dx.doi.org/10.1016/0014-5793(94)80232-7] [PMID: 7511111]
[http://dx.doi.org/10.3889/oamjms.2018.055] [PMID: 29484027]
[http://dx.doi.org/10.1038/nm1162] [PMID: 15592573]
[http://dx.doi.org/10.17795/jjnpp-20924] [PMID: 25866722]
[http://dx.doi.org/10.1016/S2221-1691(13)60105-7] [PMID: 23835719]
[PMID: 30666279]
[http://dx.doi.org/10.1016/S0190-9622(86)70201-6] [PMID: 3760276]
[http://dx.doi.org/10.1016/j.ctcp.2018.01.007] [PMID: 29705464]
[http://dx.doi.org/10.1111/j.1365-2230.1992.tb00194.x] [PMID: 1451289]
[http://dx.doi.org/10.1016/j.clim.2016.03.009] [PMID: 26993753]
[http://dx.doi.org/10.15760/etd.2684]
[http://dx.doi.org/10.2466/pr0.1982.51.2.627] [PMID: 6758013]
[http://dx.doi.org/10.1136/pgmj.49.574.591] [PMID: 4788839]
[http://dx.doi.org/10.1080/00207147308409117] [PMID: 4701785]
[http://dx.doi.org/10.2340/00015555-1719]
[http://dx.doi.org/10.1046/j.1529-8019.2003.01620.x] [PMID: 12919113]
[http://dx.doi.org/10.1038/jid.2013.508] [PMID: 24284419]
[http://dx.doi.org/10.1016/j.jaad.2011.11.948] [PMID: 22243764]
[http://dx.doi.org/10.1159/000448122] [PMID: 27536769]
[http://dx.doi.org/10.1111/joim.12093] [PMID: 23711088]
[http://dx.doi.org/10.1016/S0190-9622(98)70240-3] [PMID: 9486674]
[PMID: 12271115]