Background: Psoriasis is a common chronic, recurrent, immune mediated disease of the skin and joints. It can have a significant negative impact on the physical, emotional, and, psychosocial wellbeing of affected patients. Psoriasis is found worldwide but the prevalence varies among different ethnic groups. It has a strong genetic component but environmental factors such as infections can play an important role in the presentation of disease. There are several clinical cutaneous manifestations of psoriasis but most commonly the disease presents as chronic, symmetrical, erythematous, scaling papules and plaques. Systemic retinoids address many pathological features of psoriasis including modulating inflammatory cells, keratinocyte hyperproliferation, and differentiation. Some studies suggest that isotretinoin is ineffective in treating certain types of psoriasis, particularly plaque-type psoriasis. In fact, in early head-to-head studies, etretinate was found to be superior to isotretinion in treating most forms of psoriasis. However, with a lengthy teratogenic half-life of 120 days and reports demonstrating its presence in serum up to two years post-therapy, etretinate was removed from the market in 1997. Its successor acitretin became the only systemic retinoid with a psoriasis-approved indication. sotretinoin has been shown to manage pustular-type psoriasis with dosages ranging from 40mg/day for children to 1.5 to 2.0mg/kg/day for adults with success rates exceeding 90 percent.