Health Boards
Sun-11-01-2026, 12:41 PM
Sometimes I feel that in psoriasis and psoriatic arthritis research we are zooming in so deeply on individual details that we are starting to miss the bigger picture. We see a lot of trees, but we miss to see the whole forest.
We keep identifying new molecules, pathways and cell types, IL-17 here, IL-23 there, now EZH2, and the science behind it is impressive. But psoriasis doesn’t behave like a single-pathway disease. It behaves much more like a dysregulated system, where the immune response, metabolism, stress, environment, epigenetics and long-term “inflammatory memory” all interact. By focusing on one tree at a time, we risk losing sight of the forest. Except for our own Forest Walker of course.. hope she is doing well.
That doesn’t mean this research is useless, far from it every reseach can help vision as long as you take the time to develop that overall vision. Targeted therapies have helped many people, and mechanistic insights matter. But I do wonder whether our strong detailed approach sometimes limits our understanding.
Psoriasis may not be caused by one broken switch, but by a network that has become stuck in an inflammatory mode. Until we seriously integrate systemic, lifestyle and long-term regulatory factors into research and treatment, we may keep managing symptoms very effectively while still not fully understanding the disease itself. And I think that we over here in PC already have a much wider vision than the average derm.
We keep identifying new molecules, pathways and cell types, IL-17 here, IL-23 there, now EZH2, and the science behind it is impressive. But psoriasis doesn’t behave like a single-pathway disease. It behaves much more like a dysregulated system, where the immune response, metabolism, stress, environment, epigenetics and long-term “inflammatory memory” all interact. By focusing on one tree at a time, we risk losing sight of the forest. Except for our own Forest Walker of course.. hope she is doing well.
That doesn’t mean this research is useless, far from it every reseach can help vision as long as you take the time to develop that overall vision. Targeted therapies have helped many people, and mechanistic insights matter. But I do wonder whether our strong detailed approach sometimes limits our understanding.
Psoriasis may not be caused by one broken switch, but by a network that has become stuck in an inflammatory mode. Until we seriously integrate systemic, lifestyle and long-term regulatory factors into research and treatment, we may keep managing symptoms very effectively while still not fully understanding the disease itself. And I think that we over here in PC already have a much wider vision than the average derm.
