OBJECTIVES: Alexithymia is the inability to describe and project emotions in the self. Our objective was to assess the association between alexithymia in psoriasis (PSO) and loss of work productivity and activity in PSO patients. METHODS: EPIDEPSO (NCT01964443) is a 12-month observational, international study, to investigate alexithymia and other psychosocial comorbidities in PSO with disease duration ≤10 years. Presence of alexithymia was defined as a score of ≥61 on the 20-item Toronto Alexithymia Scale. Work productivity and activity were assessed using the Work Productivity and Activity Impairment Questionnaire: PSO (WPAI-PSO). Clinical assessments and patient-reported outcomes included the Psoriasis Area and Severity Index (PASI) and the Dermatology Life Quality Index (DLQI). RESULTS: The data displayed are from baseline analyses. The prevalence of alexithymia was 39% (95% CI 35−43%). Alexithymic patients had higher unemployment rates than non-alexithymic patients (48% vs 25%, p<0.0001). WPAI-PSO results among employed patients showed comparable absenteeism between alexithymic and non-alexithymic patients, but more impairment at work (presenteeism) (29% vs 13%) and productivity loss (34% vs 17%) was greater in alexithymic than non-alexithymic patients. In both employed and unemployed patients there was greater activity impairment among alexithymic patients (38% vs 20%, all p<0.0001). In the overall population, patients with a PASI score >10 showed more impairment at work (24% vs 15%), greater productivity loss (30% vs 18%) and  greater activity impairment (36% vs 20%) than those with a PASI score ≤10 (all p<0.01). Moderate correlations between DLQI and presenteeism (r=0.56), productivity loss (r=0.55) and activity impairment (r=0.65, all p-values <0.0001) were identified. CONCLUSIONS: In PSO patients, the inability to describe and project emotions may have an impact on daily work productivity and activity. Our data indicate that there is a complex relationship between alexithymia, disease severity, and quality of life upon employment status and productivity.