OBJECTIVES: Psoriasis is a chronic disease with significant psychosocial morbidity and lower health-related quality of life (QoL). In Sweden, an estimated 250,000 persons or nearly 3% of the population have psoriasis. There are few studies on the total cost of psoriasis therapy, especially studies that take both direct and indirect costs into account. The aim of the present study was to analyse and estimate health related QoL and costs of psoriasis during a year in relation to disease severity among psoriasis patients, based on patient populations from two dermatology centres in Sweden. METHODS: The study is based on data from three sources; a patient survey, a retrospective chart review, and data from a drug registry. Information about Qol (EQ-5D), disease severity (DLQI), resource utilisation and productivity losses was collected from patient questionnaires. Patient characteristics and type of treatment were collected from patient records. Prescribed medications were collected from national drug registry data. RESULTS: During 12 months, 64% of the patients used only emollients and topical corticosteroids and 21% used systemic treatment (not biological). During part of or during the whole period 15% used biological treatment. Mean direct cost per patient related to in and out-patient care was estimated to €488, and indirect cost was €758. Cost for drugs was €1892 per patient and cost for light treatment was €930. QoL according to EQ-5D was 0.73 (SD 0.25), VAS 72.7 (SD 20.6) and DLQI was 7.0 (SD 6.6) corresponding to “moderate effect on patient’s life”. CONCLUSIONS: Patients with more extensive psoriasis problems experienced lower QoL according to EQ-5D and higher discomfort and a larger effect on their lives according to DLQI. Direct and indirect costs increased with disease severity. Costs increased with the use of more potent drugs (biological and systemic drugs).