ABSTRACT Psoriasis is a chronic inflammatory skin disease, characterized by hyperkeratosis, thickening of the epidermis, increased vascularization and infiltration of inflammatory cells in the dermis. It affects about 2% of the world’s population and beyond the clinical severity of the lesions, having also a great impact on the patient’s quality of life. Although psoriasis seems to have a genetic background, environmental factors are necessary to trigger this disease. Given the clinical and social impact of psoriasis, the development of therapeutic strategies to this disease has generated attention. A large spectrum of therapeutic strategies is now available, with the manifestation of the disease, its severity and extension and the medical history and lifestyle of patients as key factors in the choice of the treatment. Accordingly, topical therapies using corticosteroids, clacipotriene, tazarotene and phototherapy, and systemic therapy, including the use of cyclosporin, methotrexate and retinoids, have been used in combination for the treatment of psoriasis. However, these therapeutic strategies have shown to present many adverse effects, which limit their usefulness. In face of these facts, novel drug delivery systems have been studied in order to enhance the bioavailability of drugs, target them to the skin lesions and reduce their side effects. Moreover, the development of alternative treatment for psoriasis has been supported by the understanding of the immune mechanisms involved in psoriasis associated with new developments in the treatment of other chronic inflammatory diseases and promising strategies used in oncology and in the prevention of transplant rejection. In this context, the use of photodynamic therapy, alternative immunomodulatory drugs and other T-cell targeted therapies, has been investigated in order to develop therapies with improved efficacy and tolerability compared with some conventional treatments. The present article reviews current therapies as well as the developments on new and promising strategies to treat and alleviate psoriatic disorders.
Buy this Article
|