Experimental Pharmacological Management of Psoriasis
Open accessAbstract
Psoriasis is a chronic, relapsing, immune-mediated systemic disease. Its pathogenesis is complex and not fully understood yet. Genetic and epigenetic factors interact with molecular pathways involving TNF-α, IL-23/IL-17 axis, and peculiar cytokines, as IL-36 or phosphodiesterase 4. This review discusses the mechanisms involved in the development of the disease, as well as the therapeutic options proposed following the investigation of the inflammatory psoriatic pathways. We performed a comprehensive search using the words "psoriasis" and the newest molecules currently under investigation and approval. From these data, a new scenario in psoriasis is occurring to personalize the therapies - especially systemic ones and those using small molecules - and avoid topical and injectable drugs. We reported the newest therapeutic opportunities, including the inhibitors of Janus kinase/tyrosine kinase 2, phosphodiesterase-4 and IL-36 receptor. Today, more than 20 molecules are under investigation for the treatment of cutaneous psoriasis. Most of them are constituted by small molecules or biologic therapies. This underlines how psoriasis needs systemic therapies, due to its complex pathogenesis and multisystemic involvement.
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Therapies targeting IL-17, including monoclonal antibodies against IL-17A or its receptor, produce rapid and efficient clinical responses in psoriasis by suppressing keratinocyte activation and neutrophil recruitment, which are key downstream effects of Th17 immunity.
“Therapies targeting IL-17 (monoclonal antibodies against IL-17A or its receptor) have shown rapid and efficient clinical responses by directly suppressing keratinocyte activation and neutrophil recruitment, which are key downstream effects of Th17 immunity.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [29]
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Experimental — accuracy not yet measuredSelective IL-23 inhibitors show high efficacy with durable responses in psoriasis, likely by disrupting the maintenance of disease-driving Th17 cells.
“selective IL-23 inhibitors have also shown high efficacy with durable responses, likely by disrupting the maintenance of disease-driving Th17 cells [29,30,31,32].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [29]
The Discussion (page unavailable) says IL-23 promotes Th17-cell differentiation and proliferation, supporting the proposed mechanism in broad terms. But the paper discusses inhibitors of JAK/TYK2 signalling involving IL-23, not selective IL-23 inhibitors, and does not establish their high efficacy or durable responses. (LLM, conf=0.82)
Experimental — accuracy not yet measuredThe IL-23/Th17 axis is a central driver of psoriasis.
“The identification of the IL-23/Th17 axis as a central driver of psoriasis has led to the development of biologic therapies that selectively interrupt cytokine networks.”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [29]
IL-23 is an upstream regulator of pathogenic T-cell populations in psoriasis.
“Furthermore, increasing evidence supports IL-23 as an upstream regulator of pathogenic T-cell populations; thus, selective IL-23 inhibitors have also shown high efficacy with durable responses, likely by disrupting the maintenance of disease-driving Th17 cells [29,30,31,32].”
From The Cutaneous Immune Microenvironment in Selected Inflammatory Skin Diseases: Linking Histopathology, Mechanisms, and Targeted Therapy (2026) · cites this paper as [29]
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Balato, A., Campione, E., Cirillo, T., Malara, G., Trifirò, C., Bianchi, L., & Fabbrocini, G. (2020) · Dermatologic Therapy · doi:10.1111/dth.13440 · Cited by 16 · see citing works
Self-citationEpigenetic therapy and dermatologic disease: moving beyond CTCL
Mervis, J. S., & McGee, J. S. (2018) · Journal of Dermatological Treatment · doi:10.1080/09546634.2018.1473550 · Cited by 15 · see citing works
Lanna, C., Cesaroni, G. M., Mazzilli, S., Lozzi, F., Palumbo, V., Diluvio, L., Bianchi, L., & Campione, E. (2019) · Dermatologic Therapy · doi:10.1111/dth.12946 · Cited by 13 · see citing works
Self-citationLanna, C., Cesaroni, G. M., Mazzilli, S., Bianchi, L., & Campione, E. (2019) · Diabetes Metabolic Syndrome and Obesity · doi:10.2147/dmso.s229549 · Cited by 9 · see citing works
Self-citationTreatment of psoriasis: janus kinases inhibitors and biologics for the interleukin-23/Th17 axis
Sun, C., & Xia, J. (2020) · Minerva Medica · doi:10.23736/s0026-4806.20.06460-5 · Cited by 5 · see citing works
Rodriguez-Palmero, M. (1999) · doi:10.1002/(sici)1521-4141(199912)29:12
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Cancelliere, R., Cosio, T., Campione, E., Corvino, M., D’Amico, M. P., Micheli, L., Signori, E., & Contini, G. (2023) · Frontiers in Chemistry · doi:10.3389/fchem.2023.1251360 · Cited by 48 · see citing works
Self-citationAmeliorative effects of topical ramelteon on imiquimod-induced psoriasiform inflammation in mice
Khafaji, A. W. M., Al-Zubaidy, A. A., Farhood, I. G., & Salman, H. (2024) · Naunyn-Schmiedeberg s Archives of Pharmacology · doi:10.1007/s00210-024-03017-7 · Cited by 36 · see citing works
Tsiogka, A., Gregoriou, S., Stratigos, A., Σουλαϊδόπουλος, Σ., Rompoti, N., Panagakis, P., Papoutsaki, M., Kostakis, P. G., Kontochristopoulos, G., Tsioufis, K. P., et al. (2023) · Biomedicines · doi:10.3390/biomedicines11020318 · Cited by 33 · see citing works
Attenuated effects of topical vinpocetine in an imiquimod-induced mouse model of psoriasis
Salman, H., Al-Zubaidy, A. A., Abbas, A. H., & MOHAMMAD, H. A. (2023) · Journal of Taibah University Medical Sciences · doi:10.1016/j.jtumed.2023.09.002 · Cited by 32 · see citing works
Campione, E., Mazzilli, S., Prete, M. D., Dattola, A., Cosio, T., Lettieri‐Barbato, D., Costanza, G., Lanna, C., Manfreda, V., Shumak, R. G., et al. (2022) · Frontiers in Medicine · doi:10.3389/fmed.2022.760852 · Cited by 31 · see citing works
Self-citationPsoriasis comorbidities in Germany: A population-based study on spatiotemporal variations
Augustin, J., Wolf, S., Stephan, B., Augustin, M., & Andrees, V. (2022) · PLoS ONE · doi:10.1371/journal.pone.0265741 · Cited by 21 · see citing works
Advancing insights into psoriasis: from pathogenesis to current and emerging therapies
Gonçalves, M. B. S., Fonseca, M., Mascarenhas‐Melo, F., & Figueiras, A. (2025) · International Immunopharmacology · doi:10.1016/j.intimp.2025.115429 · Cited by 22 · see citing works
Yao, P., Jia, Y., Kan, X., Chen, J., Xu, J., Xu, H., Shao, S., Ni, B., & Tang, J. (2023) · International Journal of General Medicine · doi:10.2147/ijgm.s441262 · Cited by 11 · see citing works
An overview of small-molecule agents for the treatment of psoriasis
Jin, Z., Li, G., He, D., Chen, J., Zhang, Y., Li, M., & Yao, H. (2025) · Bioorganic & Medicinal Chemistry · doi:10.1016/j.bmc.2025.118067 · Cited by 10 · see citing works
Lin, C.-Y., Yu, H., Chang, Y.-T., Lin, Z., Alalaiwe, A. S., Hwang, T., & Fang, J. (2022) · Biomaterials Science · doi:10.1039/d2bm01521h · Cited by 9 · see citing works
Reich, A., Selmer, J., Galván, J., Trebbien, P., Pi-Blanque, A., Danø, A. M., Stallknecht, S. E., & Bewley, A. (2022) · Current Medical Research and Opinion · doi:10.1080/03007995.2022.2078099 · Cited by 8 · see citing works
Jin, Q., Ren, F., & Song, P. (2023) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2023.2292605 · Cited by 7 · see citing works
Pharmacologic inhibition of Il6st/gp130 improves dermatological inflammation and pruritus
Kim, M., Kim, C., Zheng, H., Kim, Y.-R., Cho, P. S., Lim, J. Y., Choi, W.-S., Kim, M., Kim, Y., Kim, H., et al. (2024) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2024.117155 · Cited by 6 · see citing works
Lupea-Chilom, D.-S., Solovan, C. S., Farcaş, S. S., Gogulescu, A., & Andreescu, N. I. (2023) · Medicina · doi:10.3390/medicina59061015 · Cited by 6 · see citing works
Tapinarof: A Felicitous Discovery in Psoriasis Treatment
Prabath, I., Subramanian, S., & Rani, J. (2022) · Journal of Pharmacology and Pharmacotherapeutics · doi:10.1177/0976500x221130851 · Cited by 5 · see citing works
Kamaraj, C., Naveenkumar, S., Prem, P., Al‐Ghanim, K. A., Vimal, S., Jayaseelan, C., Balashanmugam, P., & Priyadharsan, A. (2024) · Journal of Industrial and Engineering Chemistry · doi:10.1016/j.jiec.2024.07.039 · Cited by 4 · see citing works
Variants in PRKCE and KLC1, Potential Regulators of Type I Psoriasis
Xing, J., Wang, Y., Zhao, X., Li, J., Hou, R., Niu, X., Yin, G., Li, X., & Zhang, K. (2022) · Clinical Cosmetic and Investigational Dermatology · doi:10.2147/ccid.s371719 · Cited by 4 · see citing works
Why targeted therapeutics have provided benefit in psoriasis: looking at IL-17 biology
Lanna, C., Lambiase, S., Shumak, R. G., Borselli, C., Cosio, T., Dattola, A., Bianchi, L., & Campione, E. (2022) · Expert Review of Clinical Pharmacology · doi:10.1080/17512433.2022.2130758 · Cited by 5 · see citing works
Self-citationPsoriasis: A Primer for General Physicians
Dasari, S., Choudhary, A. N., & Madke, B. (2023) · Cureus · doi:10.7759/cureus.38037 · Cited by 3 · see citing works
Tinca, A. C., Cozac-Szoke, A. R., & Cotoi, O. S. (2026) · Dermatopathology · doi:10.3390/dermatopathology13020022 · Cited by 1 · see citing works
“Furthermore, increasing evidence supports IL-23 as an upstream regulator of pathogenic T-cell populations; thus, selective IL-23 inhibitors have also shown high efficacy with durable responses, likely by disrupting the maintenance of disease-driving Th17 cells [29–32].”
Bernardini, N., Caldarola, G., Richetta, A. G., Esposito, M., Trovato, F., Amerio, P., Morea, E., Bonifati, C., Graceffa, D., Bruni, P. L., et al. (2025) · Dermatology Practical & Conceptual · doi:10.5826/dpc.1504a6646 · Cited by 1 · see citing works
Self-citationDevelopment and Optimization of a Tapinarof Loaded with a Proniosomal Gel to Treat Plaque Psoriasis
Godge, R. K., Gumnar, R., Vikhe, K. B., Ghogare, R. D., & Mankar, S. D. (2026) · Journal of Pharmaceutical Innovation · doi:10.1007/s12247-026-10374-8 · Cited by 1 · see citing works
Bahmani, K., Rani, N., Nasa, P., & Devi, S. (2025) · Current Physical Chemistry · doi:10.2174/0118779468355927250312073529
Skin-derived G-CSF activates pathological granulopoiesis upon psoriasis
Kosasih, T., Morishima, T., Lee, S., Yoon, J., Wakahashi, K., Kim, P., Sada, A., & Takizawa, H. (2026) · EMBO Molecular Medicine · doi:10.1038/s44321-026-00456-y
AMORE, E., Trovato, F., Pellacani, G., Dattola, A., & Richetta, A. G. (2026) · Clinical Case Reports · doi:10.1002/ccr3.72354
Self-citationInvestigational new drug TAP-1502 beginning clinical study for seborrheic dermatitis
Buttar, B. A., Subhash, S., & Feldman, S. R. (2026) · Expert Opinion on Investigational Drugs · doi:10.1080/13543784.2026.2698521
BindingDB Entry 50023112: An overview of small-molecule agents for the treatment of psoriasis.
BindingDB (2026) · UC San Diego · doi:10.7270/q2833xw3
- Authors
- Campione, E., Cosio, T., Di Prete, M., Lanna, C., Dattola, A., & Bianchi, L.
- Affiliations
- University of Rome Tor Vergata (IT)
- Corresponding author
- Campione, Elena
- Venue
- Journal of Experimental Pharmacology
- Publisher
- Informa UK Limited
- Published
- 2021-07
- Volume
- Volume 13
- Pages
- 725-737
- ISSN
- 1179-1454 (ISSN-L)
- PMC
- PMC8323855
- OpenAlex
- W3186757904
- Cited by
- 27
- References
- 91
- Citations by year
- 2026: 6 · 2025: 4 · 2024: 3 · 2023: 7 · 2022: 7
- FWCI
- 0.44
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Journal of Experimental Pharmacology (publishedVersion, cc-by-nc)
- PubMed Central (publishedVersion, cc-by-nc)
- PubMed (publishedVersion)
- IRIS Research product catalog (Sapienza University of Rome) (submittedVersion, cc-by-nc)
- Cineca Institutional Research Information System (Tor Vergata University) (submittedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
- Dove Medical Press (Taylor and Francis Group) (submittedVersion, cc-by-nc)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Rheumatology › Spondyloarthritis Studies and Treatments
- Keywords
- psoriasis, psoriasis pathogenesis, TNF-α, IL-23/IL-17 axis, IL-36, phosphodiesterase 4, JAK inhibitors, tyrosine kinase inhibitors, IL-36 receptor antagonist, small molecule therapy, biologic therapy, personalized treatment, systemic therapy
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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