PSORIASIS AS A SYSTEMIC IMMUNOMETABOLIC DISORDER

Abstract

Psoriasis has traditionally been viewed as a chronic immune‑mediated skin disease; however, emerging evidence reveals a complex systemic disorder involving immune, metabolic, gastrointestinal, and neuroendocrine dysfunction. This narrative review synthesizes current insights into the IL‑23/Th17 axis, TNF‑α and IL‑6 signaling, adipokine imbalance, insulin resistance, gut dysbiosis, intestinal permeability, and hypothalamic–pituitary–adrenal (HPA) axis dysregulation. These interconnected pathways form a self‑reinforcing inflammatory network that manifests in the skin but originates systemically. Understanding psoriasis as an immunometabolic disease highlights the need for integrated therapeutic strategies that address metabolic health, gut integrity, neuroendocrine balance, and immune modulation. This systems‑biology perspective offers a foundation for future research and more comprehensive clinical management.