OBJECTIVE: Psoriasis is a common disease with profound impact on many facets of life; there is physical impairment as well as reductions in quality of life defined by psychological, social, sexual and financial parameters. Work productivity, another important component of patients' overall well-being, has also been reported to be impacted by psoriasis. The objective of this study was to determine whether there exists a relationship between clinical severity of psoriasis and work productivity. METHODS: To quantify the impact of psoriasis on work productivity, 90 patients were surveyed in a clinic setting. Three severity groups were created based on Psoriasis Area and Severity Index (PASI) scores: mild<10, moderate=10-20, and severe>20. Work impairment was measured using the Work Productivity Assessment Index (WPAI); physical and mental health statuses were assessed using the SF-8; Anxiety/Depression was assessed using the HADS; other health and employment information were also collected. RESULTS: One-third of all subjects were unemployed at the time of the study with 16.7% of these subjects (5.5% of all 90 subjects) reporting that they were unemployed because of their psoriasis. A greater percentage of patients in the moderate and severe groups attributed their unemployment to psoriasis (33% for each), compared with the mild group (9.5%). There was a trend toward increasing impairment while at work with increasing psoriasis severity (severe 24.4%, moderate 17.7% and mild 13.5%). With respect to the percent with activity impairment, there was a statistically significant difference between the severe group (42%) and the mild group (20.2%)[all p<0.05]. CONCLUSIONS: Psoriasis is associated with work productivity impairment, and the degree of work impact, missed work, physical and mental health condition and anxiety/depression status tends to be greater in patients with more severe skin involvement. These findings support the need for aggressive but appropriate treatment of moderate-to-severe psoriasis.