Lancet - 2026-08-22 - Journal Article; Review
Psoriasis.
Eder L, Perez-Chada L, Liao W, Merola JF
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Key Takeaway
This Lancet review covers psoriasis epidemiology, immunopathology, and treatment but contains no original data, outcome metrics, or quantitative findings relevant to orthopaedic practice.
Summary Depth
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Summary
This Lancet review summarizes the pathophysiology, clinical phenotypes, comorbidities, and treatment landscape of psoriasis and psoriatic arthritis. It highlights the IL-23/IL-17 axis as the central immunological driver and the role of HLA-C*06:02 as the primary genetic risk factor. No original patient data, surgical outcomes, or quantitative comparative treatment results are reported.
Key Limitation
This paper is a general dermatology/rheumatology narrative review with no orthopaedic surgical data, making it outside the scope of the reference knowledge domain and unsuitable for evidence-based orthopaedic practice recommendations.
Original Abstract
Psoriasis is a common, chronic, immune-mediated skin disease affecting more than 40 million individuals worldwide. Psoriasis, along with psoriatic arthritis, are part of a broader psoriatic disease spectrum, and present with inflammatory skin and musculoskeletal manifestations driven by shared genetic, environmental, and immunological mechanisms. Skin psoriasis presents with diverse clinical phenotypes, including chronic plaque psoriasis, guttate, palmoplantar, erythrodermic, and pustular forms. Beyond cutaneous manifestations, psoriasis is associated with a substantial psychosocial burden and a wide range of comorbidities, including mental health disorders and cardio-metabolic diseases. Key psoriasis risk factors include genetic polymorphisms (most notably HLA-C*06:02), obesity, and environmental factors such as trauma, infections, and specific medications. Advances in understanding the key role of the IL-23-IL-17 inflammatory axis and related immunogenetic pathways have redefined psoriasis as a complex immune disorder, leading to the development of highly effective targeted biologic and small-molecule therapies that modulate cytokine signalling and intracellular pathways, offering improved disease control across cutaneous and musculoskeletal domains.