Transethosomes in Psoriasis: Mechanisms, Challenges, and Future Directions

ABSTRACT: Psoriasis is a chronic relapsing skin disease, which is associated with an immunological reaction of T-cells, resulting in increased activity of keratinocytes and an erythematous-plaque type of lesion covered with silvery-white scaling. The disease concerns 2 – 4% of the total population and exerts severe influence on the patient’s body and mind. Existing therapeutic interventions, such as corticosteroids, photochemotherapy, systemic medications, and biologics, have certain drawbacks, including reduced effectiveness, undesirable systemic effects, and high medication cost suggesting the need for new treatments. Transethosomes, a new generation lipid based vesicular system, show potential for the management of psoriasis. Transethosomes stand out as phospholipids, ethanol and surfactants; they are more flexible to deform the skin stratum corneum and psoriatic plaques with higher bioavailability and less system toxicity of drugs. It also successfully captures various categories of drugs such as methotrexate, calcipotriol, corticosteroids, biologics and phytochemicals which provides sustained drug release so that patients need less frequency to refill their prescriptions. In clinical trials, they have shown their effectiveness in the following ways; promoting better treatment responses, reducing toxicity, and allowing for the use of synergistic drugs. Still, there are issues of material formulation and the potential problems with the stability, scalability as well as regulatory constraints. Potential future enhancement can be made to technology for application of personalized medicine, targeting siRNA therapies, integrating the use of artificial intelligence with transethosomal systems. However, as this novel strategic approach in psoriasis treatment, transethosomes possess the potential for filling unsolved clinical demands, providing a targeted, effective, and patient-oriented therapy for this CN condition.