Background: Although several large observational studies have reported on psoriasis characteristics, very few have included severity assessments by dermatologists and validated health related quality of life measures. Objective: To describe psoriasis characteristics, clinical severity and their impact on quality of life of patients diagnosed with psoriasis by a dermatologist. Methods: From 2006 to 2007, 192 Belgian dermatologists examined psoriasis patients. Demographics, type of psoriasis, body sites affected, Psoriasis Area and Severity Index, Body Surface Area and Physician's Global Assessment were assessed. Patients answered questions concerning their psoriasis and completed the Dermatology Life Quality Index (DLQI), Skindex-17 and EQ-5D. Results: Of the 3,629 psoriasis patients, more than three quarters had plaque psoriasis for more than 16 years. One fifth had nail involvement, 16% had affected genitals, 15% suffered from severe joint pain, 6.4% reported psoriatic arthritis diagnosed by a rheumatologist. Despite therapy, for 83% patients the clinical psoriasis severity was relatively high (mean PASI 8.5 and %BSA12). 40% of patients reported a substantial impact of psoriasis, according to the DLQI and Skindex-17 and the mean EQ-5D scorewas 0.76. Conclusion: Psoriasis patients consulting dermatologists present with relatively severe disease and often report a high impact on their physical and psychological well-being.