Exploring Immune-genomic and Biomarker Insights in Psoriasis: Pathology of Disease and Treatment Advances

Introduction: Psoriasis is a chronic immune-mediated skin disorder characterized by immune-mediated inflammation, shaped by genetic factors, environmental influences, and immune system irregularities. Also, it is linked to various systemic health issues such as metabolic syndrome and cardiovascular diseases. This review explores the genetic and immunological underpinnings of psoriasis, emphasizing key inflammatory pathways and emerging targeted therapies. Methods: An extensive review of studies published between 1994 and 2025 was conducted, examining the genetic factors, immune responses, and inflammatory pathways in psoriasis, alongside recent therapeutic innovations. Key databases, including Google Scholar and PubMed, were searched using keywords related to psoriasis and its pathogenesis. Results: Psoriasis pathogenesis is driven by the IL-23/IL-17 axis, with Th17 cells playing a central role. Metabolic dysregulation, oxidative stress, and epigenetic changes further complicate the disease. FDA-approved biologics targeting TNF-α (Tumor Necrosis Factor), IL-17, and IL-23 have revolutionized treatment, while small-molecule inhibitors, such as PDE-4 and JAK inhibitors, provide new therapeutic avenues. Conclusion: Psoriasis remains a multifaceted condition with significant physical and psychological burdens. While biologics and novel small molecules have improved disease management, ongoing research is essential to enhance personalized treatment strategies and address comorbidities.