Background Psoriasis is a chronic, inflammatory skin disorder characterized by welldemarcated erythematous-scaly lesions, affecting 0-6.6% of the world population. Facial lesions are neglected in most descriptions in current literature, although some studies indicate that it could be a predictor of psoriasis severity. Objective To compare the severity of psoriasis, measured by the Psoriasis Area and Severity Index (PASI) and Dermatology Life Quality Index (DLQI), in patients with and without facial lesions.Material and Methods This is a cross-sectional study, whose sample size was 63 individuals for each group. Subjects were included in the HUPES Complex Dermatology Service (Salvador/BA -Brazil) from April 2014 to January 2016. Demographic information was obtained using a prestructured form. Assessments of psoriasis severity and quality of life were done using PASI and DLQI, respectively. Results Facial lesions were detected on 63 (50.0%) of the 126 patients included. The pinna was the most frequently affected region (63.5%). Mean PASI in the group with facial involvement was 14.0 vs. 6.0, when facial involvement was absent. DLQI means for these groups were, respectively, 7.5 and 4.7.Conclusions Facial involvement in a psoriasis patient was a marker of disease severity, and its identification should influence the therapeutic decision.