Abordări terapeutice convenţionale şi moderne în medicaţia topică a psoriazisului
2019
Psoriasis is an inflammatory, autoimmune dermatosis with multifactorial etiology and chronic evolution, with major repercussions on the patient’s quality of life (QoL). The main therapeutic purpose in psoriasis is to alleviate the symptomatology of the disease, to prevent recurrences and to increase the patient’s QoL. The therapeutic management of psoriasis depends on the severity of the disease. If in moderate and severe forms, topical therapy is inefficient and not considered feasible, in mild forms of psoriasis, with few plaques, topical therapy is considered a first-line treatment. Topical treatments may be indicated during psoriasis outbreaks as new lesions show up. Conventionally, the topical therapy indicated for patients with psoriasis includes corticosteroids, vitamin D analogues (calcipotriol), retinoids, calcineurin inhibitors, anthralin and tar. Although the topical medication of this condition shows several advantages, mentioning the reduced risk of side effects and treatment compliance, however, the disadvantages of this therapy should also to be highlighted, the most important being the fluctuating bioavailability determined by the skin barrier function. According to public statistics, approximately 80% of patients diagnosed with psoriasis benefit from topical therapy, but the efficiency of conventional formulations is an intense topic studied by researchers in the medical-pharmaceutical field. The development of nano pharmaceutical formulations in close correlation with the influence of nanotechnology in pharmaceutical research opens new perspectives in optimizing topical medication of psoriasis. With the advanced research of the pathophysiology of psoriasis, topical nanoformulations are studied both as administration systems for conventional drug substances, but especially for the newest therapeutic agents included in gene medication. Currently, several clinical studies with topical nanoformulations are underway to optimize the therapeutic management of psoriasis.
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