# Pathophysiologyiology and Treatment of Soriasis: From Clinical Practice to Basic Research
## 7 Future Perspectives and Conclusions  
We have reviewed the pathogenesis, clinical diagnostic methods, and commonly used clinical treatments for psoriasis, with a detailed discussion on the challenges and progress of novel transdermal drug delivery systems in psoriasis therapy. Psoriasis is becoming an increasingly serious clinical issue worldwide. Although its pathogenesis is complex, ongoing research is gradually unraveling its mysteries. Currently, psoriasis diagnosis primarily relies on physical examination by physicians, supplemented by instrumental diagnostics. In the future, by investigating the genetic background and immune response abnormalities associated with psoriasis, we may identify reliable biomarkers that enable earlier and more accurate diagnosis. Recent studies on cellular signaling pathways have provided promising new directions for psoriasis treatment, such as the development of biologics and drugs targeting inflammatory pathway factors. These therapies offer rapid results but often come with high costs. For example, the biologic drug secukinumab (Cosentyx) is priced at CNY 3000 for two doses on Chinese online platforms. Given the chronic and lifelong nature of psoriasis and the need for ongoing treatment, this can impose a significant financial burden on families. Currently, medications for psoriasis are primarily administered orally, by injection, or topically. Oral medications often cause gastrointestinal side effects and have low bioavailability. Injectable drugs, while effective, face issues with patient compliance, systemic toxicity, and high production costs with stringent quality requirements. Topical medications, on the other hand, can greatly improve patient compliance, maintain stable drug levels in the blood, and reduce side effects, making them an important approach in psoriasis treatment. However, psoriasis is characterized by significant structural and functional changes in the skin barrier, leading to excessive epidermal proliferation and keratinization. Conventional transdermal delivery systems, such as ointments and creams, often fail to sufficiently deliver and retain the medication at the target site (i.e., the deeper epidermis and dermis) or may cause systemic side effects due to the drug entering the bloodstream. The development of new transdermal drug delivery systems offers a unique opportunity for creating effective and low-toxicity treatments. For instance, a nanotechnology-based transdermal delivery system with a small size allowed deeper penetration into the skin layers while also providing benefits such as reduced dosage, increased dose dependency, higher encapsulation efficiency, controlled release, enhanced surface area, and improved bioavailability; a microneedle-based transdermal delivery system could penetrate psoriatic lesions to deliver drugs with minimal damage. However, research on novel transdermal drug delivery systems for psoriasis is still in its early stages, and there are numerous challenges, from laboratory research to market launch. The future clinical translation of these systems depends not only on their potential efficacy but also on advancements in large-scale production. Therefore, there is an urgent need not only for the exploration of new carrier systems or combination therapies but also for a focus on scalability to enable earlier market entry and deliver greater societal benefit. Conceptualization, H.Y., Z.Q., Y.G. and T.X. ; investigation, Y.W., Y.H. and S.Y. ; writing--original draft preparation, Y.G. ; writing--review and editing, Z.Q. and H.Y. ; funding acquisition, H.Y. and Z.Q. All authors have read and agreed to the published version of the manuscript. This work was supported by the Science and Technology Development Fund, Macau SAR [FDCT No.