Although the lesions of psoriasis might be "skin deep," the disease has dramatic physical,mental, social and financial ramifications for those it afflicts. Clinicians should be able to assess the impact of psoriasis on quality of life (QOL) to measure disease severity,monitor improvement, and ensure equitable funding for research and reimbursement. The development of various clinical tools to assess health-related QOL has led to increasing awareness of the extent of patient morbidity. The fact that psoriasis causes disability comparable to that seen in other major systemic diseases has important implications for how it should be viewed and treated.