For patients with genital psoriasis, disease burden can extend well beyond what conventional severity scores reflect. Intimacy, personal relationships, and sexual function may be affected even when the visible area of involvement is relatively small. Analyses from the phase 3 DERMIS-1/2 and ARRECTOR trials examined patient-reported outcomes alongside clinical improvement with roflumilast cream and foam 0.3%. These findings draw attention to dimensions of treatment response that are easily overlooked, and to the importance of asking patients about aspects of their disease they may be reluctant to raise themselves.