Establishing a successful psoriasis treatment center involves a number of practical considerations: personnel, equipment, space, economics, reimbursements, and patients. At the Psoriasis Center of Central New Jersey, which the author set up 14 years ago, patients who have moderate-to-severe psoriasis on more than 10 % of the body are treated. The goal is to provide each patient with the best risk-to-benefit ratio possible. Whether in a university setting or private practice, providing patients with all currently available therapeutic options can only be achieved using an array of technologic equipment operated by well-educated, highly trained medical staff.