title: Classical to current approach for treatment of psoriasis: a review.
abstract: Psoriasis is a genetic predisposition with T-cell mediated autoimmune inflammatory skin disorder, characterized by cutaneous inflammation, increased epidermal proliferation, hyperkeratosis, angiogenesis, and abnormal keratinization that affects up to 2 - 3% of the population worldwide. Common therapies that are used for the treatment of psoriasis include topical, systemic, phototherapy, combination, herbal therapy and novel molecules. Topically used agents include Vit D, calcipotriol, corticosteroids, dithranol and retinoids etc. Systemically used agents include methotrexate and cyclosporine etc. Phototherapy includes UV-B, Psoralen plus ultraviolet therapy and excimer laser etc. These therapies have a number of potential problems, such as limited in efficacy, inconvenience, organ toxicity, carcinogenic and broadband immunosuppression. In natural treatment a variety of natural agents such as methanolic extracts of duzhong (Eucommia ulmoides Oliv.), yerba mate (Ilex paraguariensis,) linseed oil, fish oil, and Indigo naturalis etc., that modulates T cell and cytokine action at various steps along with the pathogenic sequence have been developed. But till now there is no more in vivo, dose and its efficacy data has been established. Current therapy includes biologicals, small molecules inhibitor and enzyme inhibitors etc, which serve as novel therapeutic options for psoriasis treatment. All these avoid the side effects of the prebiologically developed systemic agents including hepatotoxicity, nephrotoxicity, and bone marrow suppression. Currently, Denilukin diftitox, Efalizumab, Alefacept, Ustekinumab and Etanercept are approved by the FDA, and others molecules are at clinical stage. Patents issued by the US office are also included in current psoriasis treatment scenario. In the United States, biologicals are widely used for moderate-to-severe psoriasis. But because of the high cost of medication and their availability in injection form, it remains to be seen how widely these agents will be utilized worldwide. Still, developing countries prefer conventional drugs.
authors.affiliation: Dreamz College of Pharmacy, Himachal Pradesh, India. mahfoozkaifi@gmail.com
authors.forename: Mahfoozur
authors.initials: M
authors.lastname: Rahman
authors.forename: Kainat
authors.initials: K
authors.lastname: Alam
authors.forename: Mohammad Zaki
authors.initials: MZ
authors.lastname: Ahmad
authors.forename: Gaurav
authors.initials: G
authors.lastname: Gupta
authors.forename: Muhammad
authors.initials: M
authors.lastname: Afzal
authors.forename: Sohail
authors.initials: S
authors.lastname: Akhter
authors.forename: Imran
authors.initials: I
authors.lastname: Kazmi
authors.lastname: Jyoti
authors.forename: Farhan Jalees
authors.initials: FJ
authors.lastname: Ahmad
authors.forename: Firoz
authors.initials: F
authors.lastname: Anwar
mesh_terms: D000818:Animals; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000627:therapeutic use; D000911:Antibodies, Monoclonal / Q000009:adverse effects / Q000627:therapeutic use; D003879:Dermatologic Agents / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D007166:Immunosuppressive Agents / Q000009:adverse effects / Q000627:therapeutic use; D007641:Keratolytic Agents / Q000009:adverse effects / Q000627:therapeutic use; D058990:Molecular Targeted Therapy / Q000639:trends; D008517:Phytotherapy / Q000009:adverse effects / Q000639:trends; D011565:Psoriasis / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism*; D011994:Recombinant Proteins / Q000009:adverse effects / Q000627:therapeutic use; D012867:Skin / Q000187:drug effects* / Q000276:immunology / Q000378:metabolism*
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000911:Antibodies, Monoclonal; D003879:Dermatologic Agents; D007166:Immunosuppressive Agents; D007641:Keratolytic Agents; D011994:Recombinant Proteins