Abstract
Background: Psoriasis is a genetically predisposed autoimmune disease mediated by cytokines released by the activated immune cells. It manifests inflammatory, scaly red or white silvery flaky skin which may be a fluid-filled lesion with soreness and itchiness. The prevalence rate of psoriasis is increasing day by day. Despite having such a high prevalence rate, the treatment of psoriasis is still limited. Hence, there is a need to rethink the various treatment strategies available in the allopathic as well as in the alternative systems of medicine.
Methods: Various bibliographic databases of previously published peer-reviewed research papers were explored and systematic data culminated in terms of various treatment strategies used for the management of psoriasis. The prime focus is given towards modern as well as alternative systems of medicine such as phototherapy, a combination of phototherapy with pharmacotherapy such as Ayurveda, Yoga and naturopathy, Unani, Siddha, and Homeopathy to treat psoriasis. Results: A comprehensive review of 161 papers, including both research and review articles, was carried out to make the article readily understandable. The pathogenesis including inflammatory mediators and type of psoriasis is discussed before the treatment strategies to understand the pathophysiology of the disease. The uniqueness, procedure, advantages, and limitations of conventional, advanced, and traditional systems of medicine to treat psoriasis are discussed in detail. Emphasis has also been given towards marine sources such as fish oil, marine sponges, and algae. Conclusion: Although there are many modern and alternative treatment strategies available to treat psoriasis, none of them have been proven to provide complete relief to patients. Moreover, they are associated with certain side effects. In order to overcome them, novel drug delivery systems have been utilized and found effective; however, their stability and safety become the major impediments towards their successful positioning. Traditional and alternative treatment strategies have found to be safe and effective but their use is localized to certain areas. In a nutshell, to achieve successful treatment of psoriasis, there is a need to focus on the development of stable and non-toxic novel drug delivery systems or the promotion of traditional systems to treat psoriasis.Keywords: Psoriasis, novel drug delivery systems, phototherapy, alternative systems, marine sources, homeopathy.
[http://dx.doi.org/10.1016/j.jaad.2016.07.064] [PMID: 28212759]
[http://dx.doi.org/10.1016/j.det.2011.08.012] [PMID: 22117868]
[http://dx.doi.org/10.1016/j.biopha.2018.06.136] [PMID: 29990862]
[http://dx.doi.org/10.1016/j.jaad.2004.07.045] [PMID: 15627076]
[http://dx.doi.org/10.1046/j.1365-4362.1997.00251.x] [PMID: 9466197]
[http://dx.doi.org/10.1016/j.cpm.2016.02.004] [PMID: 27215156]
[http://dx.doi.org/10.4103/0378-6323.72443] [PMID: 21079301]
[http://dx.doi.org/10.3390/ijms19020530] [PMID: 29425183]
[http://dx.doi.org/10.1038/nature05663] [PMID: 17314973]
[http://dx.doi.org/10.1016/j.dsi.2012.08.004]
[http://dx.doi.org/10.4103/0378-6323.115505] [PMID: 23974689]
[http://dx.doi.org/10.1038/sj.jid.5700118] [PMID: 16439971]
[http://dx.doi.org/10.1155/2013/613086] [PMID: 24069534]
[PMID: 21475522]
[http://dx.doi.org/10.1186/s13148-018-0541-9] [PMID: 30092825]
[http://dx.doi.org/10.1111/1346-8138.13806] [PMID: 28349593]
[http://dx.doi.org/10.1001/archdermatol.2011.309] [PMID: 22106115]
[http://dx.doi.org/10.4103/ijpd.IJPD_72_18]
[PMID: 20941951]
[http://dx.doi.org/10.1111/1523-1747.ep12874576] [PMID: 2299199]
[http://dx.doi.org/10.2165/0128071-200910001-00002] [PMID: 19209948]
[PMID: 12773264]
[http://dx.doi.org/10.1111/j.1365-2133.1982.tb00922.x] [PMID: 7059509]
[http://dx.doi.org/10.1016/j.clindermatol.2008.01.015] [PMID: 18691519]
[http://dx.doi.org/10.1046/j.1365-2230.2002.01148.x] [PMID: 12464150]
[http://dx.doi.org/10.1016/S0190-9622(97)80396-9] [PMID: 9270552]
[http://dx.doi.org/10.1067/mjd.2003.103] [PMID: 12734506]
[http://dx.doi.org/10.1007/978-981-10-4609-4_2]
[http://dx.doi.org/10.4103/0378-6323.178903] [PMID: 27279294]
[PMID: 11501508]
[http://dx.doi.org/10.1038/jid.2011.486] [PMID: 22402441]
[http://dx.doi.org/10.4103/2229-5178.137779] [PMID: 25165645]
[http://dx.doi.org/10.1001/archderm.1972.01620050022003] [PMID: 5060863]
[http://dx.doi.org/10.1007/s10103-017-2360-1] [PMID: 29067616]
[PMID: 11210296]
[http://dx.doi.org/10.1001/archderm.1971.04000210010003] [PMID: 5096831]
[http://dx.doi.org/10.1016/j.clindermatol.2007.11.006] [PMID: 18755362]
[PMID: 17642548]
[http://dx.doi.org/10.4065/71.12.1182] [PMID: 8945493]
[http://dx.doi.org/10.1016/S0190-9622(99)70358-0] [PMID: 10459139]
[http://dx.doi.org/10.1016/j.adengl.2013.01.001] [PMID: 23891453]
[http://dx.doi.org/10.1517/14656566.6.10.1725] [PMID: 16086658]
[http://dx.doi.org/10.1016/j.bcp.2012.01.001] [PMID: 22257911]
[http://dx.doi.org/10.1016/j.adengl.2013.03.002] [PMID: 23583515]
[http://dx.doi.org/10.1038/jid.2010.416] [PMID: 21289642]
[http://dx.doi.org/10.1046/j.1365-2133.1999.03034.x] [PMID: 10584060]
[http://dx.doi.org/10.1371/journal.pone.0181748] [PMID: 28759605]
[PMID: 18488075]
[http://dx.doi.org/10.1067/mjd.2002.127247] [PMID: 12451365]
[PMID: 22270196]
[http://dx.doi.org/10.1111/bjd.13343] [PMID: 25132294]
[http://dx.doi.org/10.4049/jimmunol.175.4.2721] [PMID: 16081850]
[http://dx.doi.org/10.1001/archderm.143.6.719] [PMID: 17576937]
[http://dx.doi.org/10.1080/21645515.2017.1356498] [PMID: 28825875]
[http://dx.doi.org/10.1136/ard.2004.030791] [PMID: 15708945]
[http://dx.doi.org/10.1067/mjd.2001.117046] [PMID: 11568737]
[http://dx.doi.org/10.9790/0853-1509122427]
[PMID: 22557623]
[http://dx.doi.org/10.1186/s13020-018-0174-0] [PMID: 29588654]
[http://dx.doi.org/10.3892/ijmm.19.3.469] [PMID: 17273796]
[http://dx.doi.org/10.1016/j.ejphar.2015.12.040] [PMID: 26738780]
[http://dx.doi.org/10.1016/j.intimp.2015.12.035] [PMID: 26784569]
[http://dx.doi.org/10.1016/j.intimp.2016.09.029] [PMID: 27697724]
[PMID: 25932143]
[http://dx.doi.org/10.4103/0973-1296.103650] [PMID: 24082629]
[PMID: 19960426]
[http://dx.doi.org/10.1016/S2221-1691(12)60021-5] [PMID: 23569912]
[http://dx.doi.org/10.5402/2012/346510] [PMID: 22536527]
[http://dx.doi.org/10.1055/s-0042-115177] [PMID: 27574899]
[PMID: 18069901]
[http://dx.doi.org/10.1016/j.ejphar.2011.04.037] [PMID: 21549694]
[http://dx.doi.org/10.1111/j.1365-2133.2005.06728.x] [PMID: 16120141]
[http://dx.doi.org/10.1016/j.bmc.2005.04.026] [PMID: 15878283]
[http://dx.doi.org/10.1016/S1011-1344(99)00135-9] [PMID: 10672536]
[http://dx.doi.org/10.1111/j.1600-0625.2007.00674.x] [PMID: 18218022]
[PMID: 15897131]
[http://dx.doi.org/10.1177/014107687907200610] [PMID: 399641]
[http://dx.doi.org/10.1159/000337936] [PMID: 22473218]
[http://dx.doi.org/10.1128/CMR.19.1.50-62.2006] [PMID: 16418522]
[http://dx.doi.org/10.3402/ljm.v8i0.22520] [PMID: 28156234]
[http://dx.doi.org/10.1111/j.1365-2184.2004.00307.x] [PMID: 15144499]
[http://dx.doi.org/10.1002/ptr.1103] [PMID: 12112282]
[http://dx.doi.org/10.1016/j.ijpharm.2005.04.031] [PMID: 15979259]
[http://dx.doi.org/10.1038/sj.bjp.0707394] [PMID: 17641670]
[http://dx.doi.org/10.3390/md8061731] [PMID: 20631865]
[http://dx.doi.org/10.3390/md16010002] [PMID: 29295585]
[http://dx.doi.org/10.1016/j.jconrel.2013.05.020] [PMID: 23770117]
[http://dx.doi.org/10.1016/S0168-3659(01)00299-1] [PMID: 11516494]
[http://dx.doi.org/10.22270/jddt.v1i2.46]
[http://dx.doi.org/10.2174/1876402911002020070]
[http://dx.doi.org/10.1016/S0168-3659(99)00247-3] [PMID: 10699286]
[http://dx.doi.org/10.1016/j.ejpb.2006.11.009] [PMID: 17196803]
[http://dx.doi.org/10.1016/0005-2736(92)90154-E] [PMID: 1550849]
[http://dx.doi.org/10.1016/S0378-5173(03)00183-2] [PMID: 12753761]
[http://dx.doi.org/10.1016/j.jconrel.2007.08.005] [PMID: 17884226]
[http://dx.doi.org/10.1111/j.1468-2494.2007.00410.x] [PMID: 18489386]
[http://dx.doi.org/10.1002/jps.21177] [PMID: 17887122]
[http://dx.doi.org/10.4103/2230-973X.85963] [PMID: 23071936]
[http://dx.doi.org/10.1016/j.ijpharm.2017.06.050] [PMID: 28629978]
[http://dx.doi.org/10.1016/j.ijpharm.2018.04.049] [PMID: 29698819]
[http://dx.doi.org/10.5138/ijdd.2010.0975.0215.02025]
[http://dx.doi.org/10.2147/IJN.S125302] [PMID: 28405165]
[http://dx.doi.org/10.1016/j.jddst.2018.12.020]
[http://dx.doi.org/10.1016/j.ijpharm.2015.04.015] [PMID: 25869452]
[http://dx.doi.org/10.1016/j.ijbiomac.2017.10.112] [PMID: 29054520]
[http://dx.doi.org/10.1016/j.msec.2018.06.049] [PMID: 30184748]
[http://dx.doi.org/10.1016/j.nano.2017.02.009] [PMID: 28259803]
[http://dx.doi.org/10.1016/j.nano.2017.02.009]
[http://dx.doi.org/10.1371/journal.pone.0115952] [PMID: 25546392]
[http://dx.doi.org/10.1016/j.ejpb.2016.06.019] [PMID: 27368748]
[http://dx.doi.org/10.1016/j.jddst.2017.07.024]
[http://dx.doi.org/10.1016/j.ijbiomac.2018.08.136] [PMID: 30171962]
[http://dx.doi.org/10.1016/j.ijpharm.2014.10.067] [PMID: 25445970]
[http://dx.doi.org/10.1016/j.colsurfb.2017.07.080] [PMID: 28779637]
[http://dx.doi.org/10.1016/j.ijpharm.2016.10.072] [PMID: 27810351]
[http://dx.doi.org/10.1016/j.jconrel.2014.09.021] [PMID: 25278258]
[http://dx.doi.org/10.1016/j.jconrel.2016.09.007] [PMID: 27639683]
[http://dx.doi.org/10.3109/10717544.2015.1110845] [PMID: 26592918]
[http://dx.doi.org/10.2147/IJN.S156412] [PMID: 29503541]
[http://dx.doi.org/10.4103/0378-6323.32709] [PMID: 17558046]
[http://dx.doi.org/10.1016/j.msec.2017.05.036] [PMID: 28629004]
[http://dx.doi.org/10.1016/j.msec.2016.07.043] [PMID: 27612773]
[http://dx.doi.org/doi:10.1016/j.ijpharm.2016.12.018] [PMID: 27956194]
[http://dx.doi.org/10.2147/IJN.S57314] [PMID: 24489470]
[http://dx.doi.org/10.7150/thno.29715] [PMID: 30662553]
[http://dx.doi.org/10.3109/1061186X.2013.771778] [PMID: 23594093]
[http://dx.doi.org/10.1016/j.nano.2017.06.009] [PMID: 28647592]
[http://dx.doi.org/10.1016/j.jconrel.2016.10.004] [PMID: 27725194]