A Clinical Review of Psoriasis and Its Association with Systemic Inflammation

Psoriasis is a prevalent chronic inflammatory skin condition characterized by hyperproliferation of keratinocytes and a dysregulated immune response, resulting in the formation of plaques and systemic manifestations. This clinical review aims to elucidate the intricate relationship between psoriasis and systemic inflammation, emphasizing the pathophysiological mechanisms, clinical implications, and potential therapeutic strategies. Recent studies have demonstrated that psoriasis is not merely a localized skin disorder but a systemic condition with significant associations with comorbidities such as cardiovascular disease, metabolic syndrome, and psoriatic arthritis. The underlying pathogenesis involves an interplay of genetic predisposition and environmental triggers that activate innate and adaptive immune pathways, leading to the overproduction of pro-inflammatory cytokines, such as tumor necrosis factor-alpha (TNF-α), interleukin-17 (IL-17), and interleukin-23 (IL-23). These cytokines contribute to both the local inflammation within psoriatic plaques and systemic inflammation, influencing the development of associated comorbidities. The review highlights the role of systemic inflammation in exacerbating the severity of psoriasis and its comorbid conditions. Evidence suggests that patients with moderate to severe psoriasis exhibit elevated levels of systemic inflammatory markers, including C-reactive protein (CRP) and interleukin-6 (IL-6), which correlate with disease severity and the risk of cardiovascular events. Furthermore, the review discusses the implications of systemic inflammation on treatment outcomes, particularly in the context of biologic therapies that target specific inflammatory pathways. In conclusion, this clinical review underscores the necessity of a holistic approach to managing psoriasis, considering its systemic implications. Future research should focus on elucidating the bidirectional relationship between psoriasis and systemic inflammation, aiming to improve patient outcomes through integrated management strategies that address both skin and systemic health. This comprehensive understanding is vital for healthcare professionals in tailoring individualized treatment plans that mitigate not only the dermatological aspects of psoriasis but also its associated systemic effects, ultimately enhancing the quality of life for affected individuals.