Psoriasis may affect all ages but typically presents in the second or third decades of life.  It is a chronic skin autoimmune disease that can also present with arthritis. The scalp, elbows, knees, buttocks and nails are commonly affected with well defined thick red scaly patches. Treatment is tailored to the areas and degree of involvement. Topical emollients, topical steroids, calcipotriene, retinoids have been standard creams utilized but now there are new targeted creams Zoryve and Vtama.  Systemic agents have included methotrexate, retinoids, and Otezla; the biologic agents such as Humira, Tremfya, Skyrizi, Cosyntex, Taltz which target the skins immune system and have changed the lives of psoriasis and prevented joint erosions and deformity.  Ultraviolet light may also improve the skin manifestations of psoriatic patients.  Some of the systemic agents require blood lab monitoring.