The development of several highly effective biologic drugs in the past decade has revolutionized the treatment of moderate-to-severe plaque psoriasis. With increased understanding of the immunopathogenesis of psoriasis, the emphasis has turned toward more specific targets for psoriasis drugs. Although the complex immunological pathway of psoriasis is not yet completely understood, current models emphasize the significant importance of interleukin (IL)-23 and IL-17. Several biologic drugs targeting these cytokines are now in various stages of drug development. Drugs targeting IL-23 include BI-655066, briakinumab, guselkumab, tildrakizumab, and ustekinumab. Drugs targeting IL-17 include brodalumab, ixekizumab, and secukinumab. While many of these have shown safety and good efficacy in clinical trials of moderate-to-severe plaque psoriasis, long-term safety is still to be established.Electronic supplementary materialThe online version of this article (doi:10.1007/s13555-015-0092-3) contains supplementary material, which is available to authorized users.

As skin ages, there is a decline in physiologic function. These changes are induced by both intrinsic (chronologic) and extrinsic (predominately UV-induced) factors. Botanicals offer potential benefits to combat some of the signs of aging. Here, we review select botanicals and the scientific evidence behind their anti-aging claims. Botanicals may offer anti-inflammatory, antioxidant, moisturizing, UV-protective, and other effects. A multitude of botanicals are listed as ingredients in popular cosmetics and cosmeceuticals, but only a select few are discussed here. These were chosen based on the availability of scientific data, personal interest of the authors, and perceived “popularity” of current cosmetic and cosmeceutical products. The botanicals reviewed here include argan oil, coconut oil, crocin, feverfew, green tea, marigold, pomegranate, and soy.

The currently approved TNF-α antagonists benefit from over 10 years of safety and efficacy data. The expense and method of administration of these biologics, however, can be cumbersome, and less expensive alternatives have the potential to benefit patients with psoriasis. It is inevitable, despite the introduction of new anti-IL-17 therapies, that established TNF-α targeted therapies, as well as newcomers targeting TNF-α, will continue to play an important role in the lifelong management of psoriasis.

Interleukin-17 has recently been identified as a key player in the pathogenesis of psoriasis. As such, several drugs targeting IL-17 are in various stages of clinical development. Areas covered: In this review, the authors describe several emerging therapies and drug candidates targeting IL-17. The authors detail many biologic injectable drug candidates as well as numerous potential oral and topical small molecule drug candidates. Expert opinion: Approval of IL-17 inhibitors has significantly improved the treatment options for psoriasis patients. Secukinumab and ixekizumab are approved in both Europe and the USA, and brodalumab is likely facing approval by the end of 2016. Numerous additional biologic and small molecule drug candidates are in the pipeline, and once deemed safe and effective will likely offer significant benefit to our psoriasis population.

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