Background/Aims: The management of psoriasis, which has a major impact on quality of life (QoL), deserves a specific attention to elderly patients' problems and needs. Our aim was to describe the QoL of elderly patients with psoriasis. Methods: This is a cross-sectional study on 305 psoriatic inpatients, aged 6 65 years. QoL, measured by the Skindex-29, was compared in groups of patients based on clinical and sociodemographic characteristics, and the possible determinants of psychological distress were investigated. Results: The mean age of the patients was 71 years (range: 65-93). Clinical severity tended to increase with age. Psychological distress was higher in patients > 70 years of age, while QoL showed an improvement for all the Skindex-29 scales in older age groups. Gender (women vs. men), and Skindex- 29 emotions and functioning scales emerged as associated with psychological distress, after adjusting for age and clinical severity. Conclusion: These observations indicate that clinical severity of psoriasis increases among very elderly patients and is associated with different levels of skin-related QoL and psychological distress. It is important for dermatologists to be aware of the specific impact of psoriasis in the different subgroups of the elderly population, to meet the peculiar needs of each group. Copyright (C) 2007 S. Karger AG, Basel.