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The pathogenesis of psoriasis is circadian\u2010rhythmic, with flares of disease and symptoms such as itch typically being worse in the evening\/night\u2010time. Patients with psoriasis have changes in circadian oscillations of blood pressure and heart rate, supporting wider circadian disruption. In addition, shift work, a circadian misalignment challenge, is associated with psoriasis. These features may be due to underlying circadian control of key effector elements known to be relevant in psoriasis such as cell cycle, proliferation, apoptosis and inflammation. Indeed, peripheral clock pathology may lead to hyperproliferation of keratinocytes in the basal layers, insufficient apoptosis of differentiating keratinocytes in psoriatic epidermis, dysregulation of skin\u2010resident and migratory immune cells and modulation of angiogenesis through circadian oscillation of vascular endothelial growth factor A (VEGF\u2010A) in epidermal keratinocytes. Chronotherapeutic effects of topical steroids and topical vitamin D analogues have been reported, suggesting that knowledge of circadian phase may improve the efficacy, and therapeutic index of treatments for psoriasis. In this viewpoint essay, we review the current literature on circadian disruption in psoriasis. We explore the hypothesis that psoriasis is circadian\u2010driven. We also suggest that investigation of the circadian components specific to psoriasis and that the in vitro investigation of circadian regulation of psoriasis will contribute to the development of a novel chronotherapeutic treatment strategy for personalised psoriasis management. We also propose that circadian oscillations of VEGF\u2010A offer an opportunity to enhance the efficacy and tolerability of a novel anti\u2010VEGF\u2010A therapeutic approach, through the timed delivery of anti\u2010VEGF\u2010A drugs.<\/jats:p>","DOI":"10.1111\/exd.14649","type":"journal-article","created":{"date-parts":[[2022,7,19]],"date-time":"2022-07-19T04:39:10Z","timestamp":1658205550000},"page":"1800-1809","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":31,"title":["Circadian rhythms in psoriasis and the potential of chronotherapy in psoriasis management"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1379-8675","authenticated-orcid":false,"given":"Andrea","family":"Luengas\u2010Martinez","sequence":"first","affiliation":[{"name":"Centre for Dermatology Research and Manchester Academic Health Science Centre The University of Manchester  Manchester 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