A review of 3D In vitro skin models for psoriasis: from pathophysiology to advanced bioengineering.

Three-dimensional (3D) skin models have become a transformative choice for replacing animal models in psoriasis research. However, the diversity of platforms, from commercial skin equivalents to organ-on-a-chip systems, has rapidly increased, posing a key selection dilemma for researchers. Based on this, we comprehensively classified the models based on their construction strategies and compared their pathological fidelity from six key dimensions: structural complexity, immune integration, vascular or neural function, scalability, primary application and recommended biological composition. Looking back at the development process of in vitro psoriasis models, it can be found that the construction strategy has gradually shifted: from static structural substitutes to dynamic systems that can reproduce natural tissue function. Although commercial models have strong standardization advantages suitable for high-throughput screening, cutting-edge bioengineering platforms including organoids and organ-on-a-chip devices have bridged the gap between laboratory constructs and clinical phenotypes by reconstructing the neural-immune-vascular axis. This review summarizes the latest progress in in vitro psoriasis modeling, explores the bottlenecks that currently exist in the system, and proposes innovative methods to provide new ideas for constructing the next-generation of models that are closer to the pathological characteristics of real psoriasis.