OBJECTIVES: To compare health-related quality of life (HRQOL) of Hungarian and Iranian psoriasis patients and to analyze possible differences in the relationship between EuroQol 5 dimensions (EQ-5D), Dermatology Life Quality Index (DLQI) and Psoriasis Area and Severity Index (PASI). METHODS: Same cross-sectional questionnaire survey was carried out in two countries. Altogether 200 adult psoriasis patients enrolled from two Hungarian university clinics and 62 from an Iranian clinic. Besides HRQOL assessment, data on demographics, applied treatments, affected body sites and clinical types were collected.   RESULTS: Mean age of the Hungarian and Iranian patients were 51.2 ±12.9 years with 69% males, and 40.4±17.5 years with 76% males, respectively. Amongst the Hungarian patients 18% used none or only topical therapy in the last 12 months, 31% systemic non-biological treatment and 52% biologicals whereas in Iran 48% of the patients applied only topicals and 39% treated with non-biological systematic therapy. Mean EQ-5D, DLQI and PASI of the Hungarian and the Iranian sample were 0.69±0.3, 6.29±7.3, 8.01±10, and 0.62±0.4, 10±6.5, 13±8.3, respectively. In both countries psoriasis of the neck and/or décolletage was associated with the greatest HRQOL reduction using either instrument (p<0.05). Regarding clinical types, in Hungary the palmoplantar involvement while in Iran nail psoriasis patients reported the worst general HRQOL (mean EQ-5D scores: 0.36±0.3 and 0.47±0.4). Correlation between EQ-5D and DLQI was found very similar across the two countries (r_s=-0.43- and -0.44, p<0.001), but EQ-5D showed significant correlation with PASI only in Hungary (r_s=-0.43, p<0.001). Strong positive correlation was identified between DLQI and PASI in both countries but only in those patients who received systemic therapy: Iran (r_s=0.72, p<0.001) and Hungary (systemic non-biological: r_s=0.65, p<0.001, biological: r_s=0.76, p<0.001).   CONCLUSIONS: Our results suggest that disease severity, treatments, and country-specific differences might lead to variations in the relationship between the outcome measures used in psoriasis.