Summary Background Caregivers must be aware of patients’ current needs by providing care responsive to patients’ values and preferences and by identifying what approach improves and encourages patients to participate in their treatment and disease management. Patients with psoriasis healthcare needs perhaps change as medical knowledge improves, new drugs emerge and the healthcare system improves its efficiency as a result of constant structural development. Objectives To explore the unmet needs and health perceptions of people with psoriasis, regarding interaction with clinicians and the structure inherent to consultations in a hospital outpatient dermatological clinic. Methods A qualitative investigation with data generated from semi‐structured interviews. Transcriptions were subsequently analysed using the template analysis method. Results Sixteen patients with psoriasis were interviewed. Challenges and dilemmas of patient‐centred psoriasis care were identified. Patients have a strong need to be met as individuals as the burden of living with psoriasis goes beyond the skin. Patients strive for efficient treatment and ultimately dream of being cured of psoriasis. They prefer individualized health education in order to adjust their knowledge and self‐management skills. These central issues are as yet rarely addressed in clinical consultations. Conclusions Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. In order to achieve a more patient‐centred approach, health professionals should implement minor structural changes to dermatological services to meet patients’ current needs and invite dialogue about the patients’ emotional well‐being and concerns that go beyond biomedical factors, as well as offer individualized health education. What's already known about this topic? There is a low level of consensus between patient and dermatologist perceptions of needs. A patient‐centred approach in managing psoriasis is increasingly recommended as it encourages patients to participate in treatment and disease management. Informed and engaged patients have better clinical outcomes, quality of life and use of healthcare resources. What does this study add? This is the first qualitative study to identify the needs and health perceptions of people with psoriasis in a hospital outpatient clinic. Patients have a strong need to be seen as individuals, and the burdens associated with psoriasis that go beyond the skin remain unaddressed in consultations. Patients’ need to be cured exceeds perceived side‐effect risks and patients need health education to adjust their knowledge and self‐management. What are the clinical implications of this work? Consultations with a standardized structure do not match the individual challenges and healthcare needs of patients with psoriasis. To achieve a more patient‐centred approach health professionals should meet patients’ current needs and talk about the patients’ emotional well‐being and concerns that go beyond biomedical factors, as well as offer individualized health education. Implementation of minor structural changes may push dermatological services to better meet patient needs. Respond to this article Plain language summary available online