Psoriasis is a chronic, immune-mediated inflammatory skin disorder characterized by keratinocyte hyperproliferation, dysregulated immune signaling and systemic comorbidities, affecting nearly 2-3% of the global population. Although conventional therapies have improved disease management, they remain limited by poor drug penetration, systemic toxicity, adverse effects, high costs and relapse after discontinuation. The distinctive pathophysiology of psoriatic skin, with its thickened stratum corneum and aberrant immune microenvironment, poses persistent challenges to achieving targeted, sustained drug delivery. To address these limitations, emerging drug delivery systems and devices are being engineered to optimize therapeutic outcomes. Nanocarrier-based platforms are enabling enhanced drug localization, improved bioavailability and modulation of key inflammatory pathways. In parallel, microneedle-assisted delivery, hydrogel scaffolds and nanofiber matrices are establishing themselves as versatile technologies for localized, sustained and patient-friendly administration. Furthermore, stimuli-responsive and bio-inspired systems, incorporating plant-derived bioactives or extracellular vesicles, are advancing the paradigm of personalized and precision medicine in dermatology. This review critically evaluates recent progress in advanced therapeutics, nanotechnology-driven platforms and bioengineered systems for psoriasis therapy, with emphasis on their mechanisms, drug targeting, translational potential and future integration into clinical practice. Additionally, this review provides insight into how advanced delivery systems may redefine the future landscape of psoriasis management.
