It has long been recognized that living with a chronic condition, such as psoriasis, can have considerable impact on the individual concerned. In turn there is increased understanding that the psychological distress encountered as a result of this experience can have implications for the course of the disease. This short review takes this as a starting point and reviews psychological influences in psoriasis. The nature of the link between psoriasis and stress is explored and its implications for the patient are discussed in psychological and clinical terms. There seems little doubt that stress, either environmental or psoriasis induced, impacts on our patients and has important implications for the management of psoriasis.