Future research

Research continues around the world into the understanding of psoriasis and its treatment. Advances are likely to occur in the field of molecular genetics in the near future, although the actual genes associated with psoriasis may not be identified for some time.

It is probably unrealistic to hope to find a complete cure for psor­iasis. However, an increased under­standing of the effects of psoriasis on epidermal cell turnover and the immunological changes that occur will undoubtedly lead to more effective – and safer – treatments. For example, we can hopefully expect newer, less-irritant, vitamin D analogues and topical retinoids.

Most research at present is into the role of the biologics, which have been reviewed. These products do address the known immunological defects found in psoriasis, but the benefits are often not great when compared with standard treatments, and the side effects have yet to be evalu­ated. They are hugely expensive and have to be given by injection.

Work is in its infancy on the use of photodynamic treatment of psoriasis, where certain porphyrin chemicals are applied to the skin and then exposed to visible light from special lamps. This treat­ment is already being used for the treatment of non-melanoma skin cancers in many centres around the world.