Psoriasis is a common, chronic, inflammatory disease of the skin and joints. Use of traditional oral systemic therapies for moderate to severe psoriasis such as methotrexate, acitretin, and cyclosporine may be limited by patient intolerance or organ-specific toxic effects. Several new biologic drugs have been approved for the treatment of moderate to severe psoriasis, but they are associated with high costs, diminished efficacy during long-term treatment, and risks of rare but serious adverse effects. In this cross-sectional study, Gelfand et al demonstrate that patients taking adalimumab, etanercept, and ustekinumab were more likely to have clear or almost clear skin compared with those taking methotrexate. Patients receiving phototherapy showed no difference compared with methotrexate.