Indian Journal of Dermatology
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IJD SYMPOSIUM
Year : 2022  |  Volume : 67  |  Issue : 4  |  Page : 360-373

Recent update on immunopathogenesis of psoriasis


1 From the Department of Immunopathology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
2 Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
3 Department of Medicine and Infectious Diseases, VA Northern California Health Care System, 10535 Hospital Way, Mather, CA, United States
4 Department of Medicine and Infectious Diseases, VA Northern California Health Care System, 10535 Hospital Way, Mather; Department of Dermatology, Division of Rheumatology, Allergy and Clinical Immunology, University of California Davis, School of Medicine, Davis, CA, United States

Correspondence Address:
Siba P Raychaudhuri
Professor, Division of Rheumatology, Allergy and Clinical Immunology, University of California Davis, School of Medicine, Program Director Rheumatology, Chief of Rheumatology, VA Northern California Health Care System, 10535 Hospital Way, Mather, CA - 95655
United States
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/ijd.ijd_569_22

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Psoriasis is a chronic disabling complex inflammatory disorder prevalent worldwide with environmental and genetic components that involve predominantly skin in addition to nails and joints associated with various systemic comorbidities having periods of exacerbations and remissions. Psoriasis is characterized by hyper-proliferation as well as abnormal differentiation of epidermal keratinocytes and lymphocyte infiltration (mainly T cells) with resultant inflammatory cytokines and chemokines. Immunological and genetic studies over the last decade have identified genetic susceptibility risk alleles, molecular, cellular and immunological mechanisms involved in immunopathogenesis of psoriasis. The current disease model emphasizes the role of aberrant Th1 and Th17 responses regulated by a complex network of different cytokines, including TNF-α, IL-17 and IL-23; signal transduction pathways downstream to the cytokine receptors; and various activated transcription factors, including NF-κB, interferon regulatory factors and signal transducer and activator of transcriptions. Cytokines targeting biologics (IL-17, IL-23 and TNFα) therapies have revolutionized the management of severe skin disease having beneficial effects on joints and systemic inflammation of psoriasis as well. Further better understanding of immunopathogenesis of psoriasis will pave way for precision medicine based on specific immunopathogenic targets in a given phenotype of disease. Complex interplay of psoriasis with associated comorbidities is also a future area of research for overall better patient management and to improve their quality of life.


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