Background: Thrombomodulin (TM) is a glycoprotein presented as a transmembrane molecule on the surface of the cell. It was originally recognized in vascular endothelium. TM is one of the natural anticoagulant mechanisms. TM has also anti-inflammatory functions in addition to its function in hemostasis. TM is an important cofactor that influences various biological conditions. Inflammatory and thrombotic disorders can display changes in TM expression and its partner proteins. On the other hand, in multiple autoimmune inflammatory disorders, several previous studies have recognized TM as a cofactor. TM was also recognized in other types of the cells rather than the vascular endothelium, including the epidermal keratinocytes. However, the function of TM in the skin and its role in the pathogenesis of skin diseases has been investigated in only a few studies.Objective: to highlights the recent findings relevant to the role of TM in the skin and some dermatological diseases including psoriasis.Conclusion: TM has diverse and complex functions other than its role as an anticoagulant protein making it a target in the future for various approaches to the treatment of several inflammatory, proliferative and immune-mediated disorders.