Treatment of psoriasis: before and now Psoriasis is a multisystem inflammatory disease primarily affecting the skin. Despite its prevalence and considerable effect on quality of life, psoriasis is still underdiagnosed and undertreated. Many patients seek initial evaluation and treatment at primary care level and therefore it is important to know that treatment of psoriasis has advanced tremendously in recent years. Decisions on psoriasis management should be based on assessment of disease severity and phenotype, the existence of physical and psychological comorbidities, the need for referral to dermatologist for specialist care, the patient's preferences and, when possible, identification and elimination of psoriasis trigger factors. Individual treatment goals should be agreed with the patient and treatment should aim to achieve these goals. An individualized, patient centered approach based on the potential of current treatments and a good interpersonal communication between patient and doctor, is essential for effective management of psoriasis.