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Background Topical agents are an essential component of psoriasis therapy. Objectives To develop a new version of the patient-reported Patient Benefit Index assessing the importance and achievement of treatment goals in topical psoriasis therapy in adult patients (PBI-TOP). Methods Through semi-structured interviews, focus groups and free-text questionnaires, patients reported their needs in topical treatment. Based on qualitative content analysis, items were developed by a consensus group and were refined in cognitive debriefing interviews. A pilot validation assessed the PBI-TOP and convergent criteria [Dermatology Life Quality Index (DLQI); Psoriasis Area and Severity Index (PASI); affected Body Surface Area (BSA)]. Results Thirty patients (26–72 years, mean 47; 60% male) reported various treatment goals relating to the themes 'effectiveness' and 'characteristics of the preparation'. Twenty patients took part in cognitive debriefings (22–84 years, mean 50.6, 50% male). There were 154 patients who participated in the pilot validation (18–85 years, mean 46.9, 63.6% male). An importance-weighted total score on overall effectiveness and three subscales based on exploratory factor analysis were defined: effectiveness on symptoms, effectiveness on quality of life (QoL), and characteristics of the preparation. All scores showed excellent internal consistency (α > 0.9). The global effectiveness score correlated significantly with DLQI (r = –0.41), PASI (r = –0.32) and BSA (r = –0.22). The effectiveness subscales (symptoms; QoL) correlated significantly with DLQI (r = –0.41; –0.32) and PASI (r = –0.27; –0.33). The score on characteristics of the preparation correlated significantly with the DLQI (r = –0.34). Conclusions The PBI-TOP showed good feasibility and favourable psychometric characteristics in this pilot validation. [ABSTRACT FROM AUTHOR]