PSORIASIS: IMMUNOLOGIC MECHANISMS AND MODERN BIOLOGIC THERAPY — A DERMATOLOGY PERSPECTIVE
Keywords:
Psoriasis, IL-23/Th17 axis, keratinocyte hyperproliferation, TNF-alpha inhibitors, IL-17 inhibitors, IL-23 inhibitors, biologic therapy, PASI, psoriatic comorbidities.Abstract
Psoriasis is a chronic, immune-mediated inflammatory skin disease with substantial global disease burden, increasingly recognized as a systemic condition with significant comorbidities. This narrative review synthesizes current evidence on the immunopathogenesis, clinical features, diagnosis, and treatment of psoriasis, drawing on systematic reviews, randomized controlled trials, and consensus clinical guidelines, supplemented with regional epidemiological data and clinical guidance specific to Uzbekistan. The pathogenesis of psoriasis centers on dysregulation of the IL-23/Th17 immune axis, driving keratinocyte hyperproliferation and sustained cutaneous inflammation. Diagnosis remains primarily clinical, supported by severity indices such as PASI and BSA, while treatment has been transformed by biologic agents targeting TNF-alpha, IL-17, and IL-23, which offer substantially improved efficacy and safety compared with conventional systemic therapy in moderate-to-severe disease. Advances in understanding psoriasis immunopathogenesis have translated directly into targeted biologic therapies that meaningfully improve disease control and quality of life; expanding access to these therapies, including within the healthcare system of Uzbekistan, remains an important priority.
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