fig1

Figure 1. Treatment Strategy for Psoriasis: Stepwise Approach Based on Disease Severity. This schematic summarizes the current therapeutic hierarchy for psoriasis, illustrating treatment escalation from mild to severe disease. Mild psoriasis is managed primarily with topical therapies such as corticosteroids, vitamin D analogues, calcineurin inhibitors, retinoids, keratolytics, and newer non-steroidal agents (AhR agonists, PDE4 inhibitors). For moderate disease, phototherapy (narrowband UVB, PUVA, excimer laser) and systemic non-biologic agents (methotrexate, cyclosporine, acitretin, apremilast, deucravacitinib) are employed. In moderate-to-severe cases, biologic therapies targeting IL-23 (guselkumab, risankizumab) and IL-17 (secukinumab, ixekizumab) provide the highest efficacy and durability. AhR: Aryl hydrocarbon receptor; PDE4: phosphodiesterase 4; UVB: ultraviolet B; PUVA: psoralen plus ultraviolet A; TYK2: tyrosine kinase 2; IL-23: interleukin-23; IL-17: interleukin-17.