Abstract: 【Abstract】 As highly heterogeneous vascular functional units, skin vascular endothelial cells （ECs） play a dynamic regulatory role in the pathological process of psoriasis by sensing and integrating multidimensional signals in the immune-inflammatory microenvironment. Skin ECs play a dual role in the occurrence and development of psoriasis: as "sensors," they decode microenvironmental signals such as inflammatory factors and metabolites in real time, driving vascular barrier dysfunction and immune cell infiltration; as "effectors," ECs actively participate in amplifying T helper 17 （Th17） immune responses and maintaining the inflammatory tissue microenvironment by secreting vasoactive mediators, remodeling epigenetic profiles, and forming inflammatory memory. The bidirectional interaction between capillary loop ECs in the dermal papillary layer and the immune microenvironment constitutes a "vascular-immune" positive feedback loop, serving as a critical hub connecting skin and systemic immune dysregulation. Future research should transcend the traditional paradigm of "passive vascular response," focus on the regulatory role of EC spatiotemporal heterogeneity in psoriasis comorbidities, and develop novel therapeutic strategies based on vascular function restoration, offering new insights for controlling the recurrence of psoriasis and the occurrence of its comorbidities.

Key words: Psoriasis, Endothelial cells, Endothelial dysfunction, Inflammatory microenvironment, Therapeutic targets