JCMS editor-in-chief Dr Kirk Barber speaks with Dr Patrick Fleming, one of the authors of a new manuscript that offers an extensive comparison of international guidelines on a wide range of therapies for the treatment of moderate-to-severe plaque psoriasis from phototherapy, to biologics to molecule-based strategies. Dr Fleming and his co-authors looked at the guidelines in Canada, the United Kingdom, Europe and the United States. In this conversation, Dr Fleming highlights some surprising differences their research revealed between Canada and the US guidelines. And both Dr Barber and Dr Fleming share how their own clinical practices compare to the guidelines.Dr. Patrick Fleming is a Royal College-certified dermatologist practising in Markham, Ontario.