OBJECTIVES: Several treatment options are available for psoriasis, an incurable dermatological condition, but there is limited information on actual treatment patterns. This retrospective study aimed to provide a snap shot of the use of psoriasis medications and recent trends over time in current clinical practice in psoriasis patients with co-morbid conditions. METHODS: Adult patients with ≥2 documented psoriasis diagnoses (ICD-9 codes: 696.1 were selected from a large US administrative claims database (2004-2008). The index date was defined as the latest date with a psoriasis diagnosis. Psoriasis treatments, including topical therapies, phototherapy, conventional systemic therapies, and biologics, were identified during the 6 months following the index date and described for the entire psoriasis population, a sub-group of obese patients (body mass index [BMI] ≥30), and stratified by index year to examine trends over time. RESULTS: A total of 106,128 psoriasis patients were selected. The mean age was 52±15 years and 52% were female. Overall, 62.3% of psoriasis patients were on topical therapies, 12.1% used biologics, 7.4% used other immunosuppressant agents, 5.6% used phototherapy and 27.2% were untreated. Over time, biologic use increased from 8.7% in 2004 to 21.0% in 2008, while the use of other treatments did not show this trend. In the sub-group of psoriasis patients with BMI information (N=1874; 646 obese and 1,228 non-obese), more obese patients were treated with biologics (20.0% vs. 15.0%) and other immunosuppressant agents (12.4% vs. 6.9%) than non-obese patients. CONCLUSIONS: The majority of psoriasis patients were treated with topical therapies. There has been an increase in the proportion of patients using biologics in the recent years. In addition, biologics and other immunosuppressant therapies were more likely to be used among obese patients.