Psoriasis is now understood as a systemic immune-mediated disease with heterogeneous phenotypes, significant quality-of-life burden, and elevated cardiometabolic risk. Globally, at least 125 million people, approximately 2-3 per cent of the population (1), are estimated to live with psoriasis, though prevalence varies widely by geography and method of ascertainment.
For patients, the impact is twofold. On the surface, psoriasis can cause persistent itching, burning, and discomfort. But equally significant are the psychosocial burdens — lowered self-esteem, social withdrawal, and higher rates of anxiety and depression. This disease is also associated with psoriatic arthritis and an increased risk of other conditions, particularly cardiovascular disease, which should be factored into treatment planning and longitudinal follow-up (2). These dimensions make psoriasis not just a dermatological concern, but a condition that shapes overall quality of life.
Advancements in the treatment landscape
Historically, treatment revolved around topical agents, phototherapy, and systemic immunosuppressants, which often provided temporary relief but did not fully address the underlying immune dysfunction. Today, however, advances in immunology and targeted therapies are reshaping the treatment paradigm, offering long-term disease control and renewed hope for patients. The greatest breakthrough has come with biologic therapies. These are targeted treatments that block specific immune pathways — particularly TNF-alpha, IL-17, and IL-23 — which drive the overactive immune response in psoriasis. A meta-analysis of PASI-75 responses at 12 weeks found weighted average Psoriasis Area and Severity Index (PASI)-75 scores of 78.6 per cent for infliximab, 72.1 per cent for ustekinumab, 70.5 per cent for adalimumab, 48.1 per cent for etanercept, and 21 per cent for alefacept (3)
Compared to traditional systemic drugs, biologics offer:
- Higher efficacy, with many patients achieving 75–90 per cent improvement in the severity of their disease (4).
- Improved quality of life, reducing itching, scaling, and emotional distress (5)
- Long-term disease control, with sustained remission in some patients (6)
- Systemic benefits, including lowering the risk of psoriatic arthritis and cardiovascular complications by controlling chronic inflammation (7)
For patients, this means that treatment is no longer just about suppressing skin lesions, but also about protecting overall health and long-term quality of life. Many who come into the clinic with this condition describe a dramatic improvement in confidence, mobility, and daily functioning once it is under control. However, accessibility and affordability remain significant barriers, particularly in developing countries, underscoring the need for greater awareness and healthcare equity.
It is important to stress that biologics require specialist assessment, appropriate screening (e.g., TB, hepatitis), and ongoing monitoring for safety and effectiveness. In India, access to psoriasis treatment with biologicals like IL17 inhibitors is expanding, but remains concentrated in advanced centres with the necessary expertise and infrastructure. Clinics such as The Esthetic Clinics(TEC) provide multidisciplinary evaluation and follow-up protocols that are essential for delivering these therapies safely and effectively. Offering clearance rates of 97 per cent, TEC has been integral to the evolution of psoriasis treatment in India. Studies on practical real-time experience with these biologicals are underway at TEC so that the benefits and experiences with these treatments may reach the needy population.
Digital tools & AI transforming Psoriasis care
Digital tools are reshaping psoriasis management, enhancing both clinical efficiency and patient engagement. A randomised controlled trial published in the British Journal of Dermatology, for instance, demonstrated that a smartphone application supporting patients with psoriasis significantly improved short-term adherence to topical treatment. Patients using the app showed a 65 per cent adherence rate compared to 38 per cent in the control group at week 4. Additionally, the intervention group exhibited greater reductions in psoriasis severity, as measured by the Investigator’s Global Assessment (IGA) score (8)
Artificial intelligence is further advancing the objective assessment of psoriasis severity. A study integrating an AI-based model into the SkinTeller app demonstrated its ability to accurately estimate Psoriasis Area and Severity Index (PASI) scores, aligning closely with clinician evaluations (9). AI-powered imaging platforms are also enhancing lesion tracking and monitoring. For instance, there are now platforms that use deep learning algorithms to analyse skin lesions, aiding in the early detection of changes and improving diagnostic accuracy.
Interestingly, AI also shows promise in predicting treatment outcomes. Models can forecast patient response to biologic therapies with over 95 per cent accuracy within 2–4 weeks of treatment initiation, substantially shortening the conventional 12-week evaluation period. Similarly, machine learning approaches are being used to predict phototherapy outcomes with high sensitivity (>84 per cent) and accuracy (75–85 per cent), supporting personalised treatment decisions and optimising therapeutic efficacy (10)
These advancements in digital tools and AI are not only improving clinical outcomes but also empowering patients to take an active role in managing their condition. As technology continues to evolve, its integration into psoriasis care promises more personalised and efficient treatment pathways.
Looking ahead
Future breakthroughs are likely to emerge from biomarker-guided approaches, enabling clinicians to tailor therapies based on a patient’s genetic profile, immune status, and real-time adherence data. At the same time, the integration of teledermatology, AI-assisted severity assessment, and digitally enabled care pathways is expanding access to specialist care while allowing for continuous, individualised monitoring. By combining these technological innovations with high-efficacy therapies within structured treat-to-target frameworks, clinicians can translate scientific insights into meaningful, patient-relevant outcomes. This approach not only optimises clinical remission but also empowers patients to actively participate in their care, creating a sustainable model of psoriasis management that is both precise and responsive to the complexities of individual disease patterns.
Conclusion
Psoriasis is a complex, systemic disease, and the way we manage it is evolving like never before. Biologic therapies have opened doors to outcomes once thought impossible, giving patients more than clearer skin—they are reclaiming confidence, mobility, and quality of life. On top of this, digital tools and AI innovations are further improving and streamlining day-to-day care, allowing clinicians to track progress, predict responses, and intervene sooner than ever before. The future is bright: personalised treatment guided by biomarkers, teledermatology, and intelligent monitoring could make every patient feel seen, supported, and in control.
References:
- https://www.psoriasis.org/psoriasis-statistics/
- https://www.who.int/publications/i/item/global-report-on-psoriasis
- https://pubmed.ncbi.nlm.nih.gov/22967166/
- https://www.self.com/story/questions-about-biologics-for-psoriasis
- https://pubmed.ncbi.nlm.nih.gov/35637943/
- https://pubmed.ncbi.nlm.nih.gov/38113010/
- https://pubmed.ncbi.nlm.nih.gov/40245096/
- https://pubmed.ncbi.nlm.nih.gov/29654699/
- https://pmc.ncbi.nlm.nih.gov/articles/PMC10131673/
- https://journals.lww.com/idoj/fulltext/9900/insights_into_the_impact_of_artificial.499.aspx