Psoriasis treatment has advanced significantly over the last few decades. In the mid-1990s, treatment for severe cases involved rotating low-to-medium efficacy therapies like topical treatments, phototherapy, and oral medications, offering only temporary relief. The introduction of first-generation biologics changed the landscape, leading to longer and more complete remissions. More recently, novel biologics have shown superior results, allowing for more ambitious treatment goals, with long-term remission off-treatment now being a realistic possibility.

Despite these advancements, dermatologists face ongoing challenges in providing optimal care due to expanding indications, growing patient populations, and rising medication costs. The article by Speeckaert et al. explores how integrating new developments, such as personalized dosing, telemedicine, and updated treatment goals, could enable more sustainable care. The authors also critique current reimbursement policies, suggesting that restrictions on biologic access delay optimal treatment. They call for harmonizing treatment standards across European countries to ensure patients receive the most effective therapies for sustainable care.

Reference: Gyulai R. Closing the gap between possibilities and reality in psoriasis management. J Eur Acad Dermatol Venereol. 2025 Mar;39(3):449-450. doi: 10.1111/jdv.20546. PMID: 39996341; PMCID: PMC11851251.