Classical wisdom and modern science: Traditional Chinese Medicine compounds in the treatment of psoriasis – A narrative review

Psoriasis is a chronic immune-mediated skin disorder characterized by aberrant T cell activation, keratinocyte hyperproliferation, and persistent inflammation. Although biologic therapies targeting key cytokines, such as interleukin (IL)-17A and IL-23, have improved disease management, issues related to cost, safety, and relapse necessitate the development of alternative or adjunctive treatments. With its long history of treating inflammatory skin diseases, Traditional Chinese Medicine (TCM) offers a valuable source of bioactive compounds with immunomodulatory potential. The present review summarizes representative TCM-derived compounds exhibiting anti-psoriatic activities, focusing on their molecular targets, pharmacological mechanisms, and translational relevance. A comprehensive literature search was conducted in PubMed and Web of Science from 2000 to 2024 using predefined keywords related to psoriasis and TCM. The inclusion criteria were original research and review articles reporting mechanistic or therapeutic evidence. Key phytochemicals—including flavonoids and terpenoids—were found to suppress proinflammatory cytokines, inhibit signal transducer and activator of transcription 3 and nuclear factor kappa B signaling, reduce proinflammatory cytokine expression, and restore T helper 17/regulatory T cell balance in various experimental models. In vitro studies using activated CD4⁺ T cells and keratinocyte cultures have demonstrated their ability to reduce cytokine secretion and downregulate inflammatory gene expression. Despite promising preclinical findings, standardizing herbal extracts, ensuring long-term safety, and overcoming poor bioavailability through improved formulations remain challenging. Future research integrating omics technologies, rational drug design, and controlled clinical studies will be essential to advance these compounds toward clinical use. In conclusion, TCM-derived compounds represent a promising frontier for the development of multifunctional therapies for psoriasis and offer considerable potential for their integration into modern dermatological practice.