BACKGROUND: Psoriasis is an chronic inflammatory disease of the skin affecting approximately 1-3% of population worldwide, almost 2% in Europe and 2.8% in Italy. Psoriasis has been associated with several comorbidities as arthropathy, inflammatory bowel diseases, eye diseases, metabolic diseases and psychological disorders. OBJECTIVES: The main objective of the study is to design an optimized Patient Diagnostic Therapeutic Pathway for the Tuscany Region (Italy) characterized by higher quality of care and higher levels of organizational and economic efficiency. METHODS: Research and analysis of the scientific literature and of the clinical guidelines on the main dimensions of psoriasis and patient care. Design of ad hoc questionnaire useful to collect data and information regarding both the organizational structure of the 13 Centers and the different phases of patients pathways. Conduction of  semi-structured interviews to the clinicians. Realization of 13 flow charts representing the patients pathways, from the pre-diagnosis phase to the follow-up phase. RESULTS: The analysis shows similarities between the Centers in the phases of treatment and follow-up, principally due to their clinical nature. Major organizational differences have been recorded in the pre- diagnosis and the diagnosis phases due to dissimilar modalities of enrolment of patients. The analysis of the thirteen patients pathways has allowed the identification of an unique optimized pathway with improved characteristics for the patient. The diffusion of the optimized pathway will favour the adoption of a virtuous cycle of dialogue between the professionals and the progressive "homogenization" of some phases of the hospital management of the patient with psoriasis. CONCLUSIONS: The study identifies an optimized pathway - able to engage all the clinicians involved in the care of the patient and his/her comorbidities - to be adopted at the regional level for a more effective, more integrated and efficient management of psoriasis.