Molecular Insights into Psoriasis: Connecting Pathophysiology to Drug Therapy

Abstract

Psoriasis is a chronic, immune-mediated inflammatory skin disorder with systemic manifestations. Characterised by erythematous plaques with silvery scales, it is driven by a complex interplay of genetic predisposition, environmental triggers, and immune system dysregulation, particularly involving Th1 and Th17 cell pathways.

This chapter offers a comprehensive overview of the molecular pathology underlying psoriasis, including key immunologic and histopathologic changes such as keratinocyte hyperproliferation, parakeratosis, Munro microabscesses, and dermal angiogenesis. It further explores the correlation between these pathological features and therapeutic interventions, ranging from traditional topical agents to advanced biologic therapies targeting cytokines like TNF-\(\alpha\), IL-17, and IL-23. Additionally, the chapter addresses the significance of comorbid conditions, such as psoriatic arthritis and cardiovascular disease, emphasising the need for early diagnosis and tailored management. Through this integration of pathophysiological insights and pharmacological strategies, the chapter underscores a personalised, targeted approach to psoriasis care.