A 31-year-old Caucasian man presented to the clinic for the treatment of long-standing plaque-type psoriasis. On physical examination, he had moderate plaque-type psoriasis on the bilateral elbows, knees, palms, and axillae, affecting approximately six percent of his body surface area. In addition, he had pitting of the finger nails. The patient had no signs or symptoms of arthritis and was otherwise healthy, taking no medications. He had no known drug allergies. Past treatment for his psoriasis included topical steroids and vitamin D analogs. These were efficacious on the elbows and knees and temporarily efficacious on the palms. He stopped treating his palms because he disliked the ointment vehicles of the medications. His major complaint was psoriasis on the palms and axillae. He had used topical calcineurin inhibitors in the past in the axillae, but discontinued them because of burning at the application sites. He was given coal tar 2% foam to use twice daily on the palms and axillae. On follow-up visit at Week 8, the plaques were significantly improved (Figures (Figures11 and and2).2). The axillae were clear with residual hyperpigmentation, and the palms were almost clear. The patient had no complaints with the coal tar foam. The patient did not report staining of clothing or skin while using the tar foam.