Objective:

To evaluate the role of inflammatory biomarkers in assessing disease severity and treatment efficacy in chronic inflammatory skin diseases (CISDs) including psoriasis, atopic dermatitis, and hidradenitis suppurativa, with a focus on improving treatment strategies.

Key Findings:

• The Fas/FasL axis contributes to chronic inflammation but evidence in HS is limited, indicating a need for targeted research.
• IL-21 is linked to Th1 and Th17 activation and shows promise as a biomarker in PsO and AD, with a knowledge gap in HS that warrants further investigation.
• CBC-derived inflammatory indices may correlate with disease activity and treatment response, but findings are inconsistent, necessitating standardization for clinical use.

Interpretation:

The findings highlight the complexity of immune-mediated pathways in CISDs and suggest that biomarkers could significantly enhance disease monitoring and treatment personalization, paving the way for future research.

Limitations:

• Limited evidence for the role of certain biomarkers, particularly in HS, which may affect the generalizability of findings.
• Heterogeneity in findings regarding CBC-derived indices necessitates standardization to ensure reliable clinical application.
• Current studies are primarily retrospective, indicating a need for prospective validation to strengthen the evidence base.

Conclusion:

Integrating various biomarkers could lead to improved disease management strategies in CISDs, although further research is urgently needed to validate these findings and their clinical applicability.