OBJECTIVES: Severe psoriasis can result in considerable decrease in quality of life, and this is likely to be reflected in an increase in costs. The purpose of this study was characterise resource use in those with psoriasis and determine if there exists an association between psoriasis severity and hospital resource use. METHODS: Psoriasis patients were identified at hospital clinic, and sent the HODaR survey which also included the Dermatology Life Quality Index (DLQI). The DLQI was used to classify severity. Data concerning each patients' hospital admissions and outpatient attendances were identified from the patient records, other resources such as GP attendances were self reported by survey. This data was collected over a number of years and an average yearly rate computed. RESULTS: There were 94 respondents to the survey. The mean time since diagnosis was 15.6 years and 50% were male. Treatment was reported as follows: topical cream 70.2%, acitretin 14.9%, no reported treatment 10.6%, methotrexate 2.1%, cyclosporine 1.1 and PUVA 1.1%. Retinoid treated patients were more likely to be male and topical cream treated subjects were more likely to be female. The mean number of GP consultations in the previous year was 2.79 per subject, hospital Admissions 2.22, and outpatients attendances 4.70. Resource use varied by disease severity. By DLQI score (<3, 3<6, 6<10, and =10, units respectively), subjects reported the following mean number of GP consultations in the previous year: 13, 20, 15, and 24, respectively (p <0.01 [test for trend]). For outpatient attendances: 15, 16, 8, and 19, respectively (p <0.05). For bed occupancy in the previous year: 19.8, 21.7, 17.5, and 58.7 days, respectively (p <0.01). CONCLUSION: Patients with psoriasis managed in UK hospitals represent a considerable financial burden, and this burden increases with increasing disease severity. Measured should be taken to reduce the severity of psoriasis.