OBJECTIVES: The registry “PsoBest” observes systemic therapy of moderate and severe psoriasis/psoriasis-arthritis in Germany since 2008. The registry is supported by the German society for dermatologists, the association of dermatologists, pharmaceutical manufactures, dermatologists and patients. It is located at CVderm and records efficacy, safety, and patient benefit in routine health care. One purpose of PsoBest is to monitor health related quality of life (HrQoL) and severity of psoriasis in the process of care. METHODS: Patients receiving first time a conventional systemic or biologic therapeutic are observed for 5 years, independent of further treatment. Standardised questionnaires for physicians and patients are compiled. Main outcomes are severity (PASI), affected body surface area (BSA) and HrQoL (DLQI and EQ-5D). RESULTS: A total of 1,984 patients were enrolled up to July 2012 (60% male, mean age of 47 years); mean duration of illness was 19±14 years. Patients on biologics (n=686) tended to be male (63 v. 58%), older (48.1 v. 46.7 years) as patients on conventional systemics (n=1,298) and had a longer history of psoriasis (21.9 v. 16.8 years). The biologic cohort showed more nail involvement (64 v. 52%), signs of arthritis (47 v. 17%), higher severity (PASI: 15.6 v. 14.6; BSA: 22. v. 21.5) and lower HrQoL (DLQI: 11.7 v. 11.0; EQ-5D VAS: 50.6 v. 55.7). For the biologics cohort, mean PASI improved to 4.5 between 12 and 24 months (reduction of 70% from baseline). Moreover, HrQoL (DLQI) improved by 65% from inclusion. The conventional systemics cohort showed comparable reduction in PASI=3.1 (77%) but less improvement in DLQI= 3.1 (49%). CONCLUSIONS: PsoBest provides long-term real-world data on psoriasis care in Germany. The results show the high burden of psoriasis patients entering the registry and also the high quality of care and patient benefit after initiation of systemic treatment.