The contribution of dermatologists’ practices to existing disparities in psoriasis treatment remains unknown. We aimed to evaluate whether patient race, gender, or socioeconomic status affect dermatologists’ management of psoriasis. We conducted a cross-sectional survey study of a random sample of dermatologists (N=3,352) who are members of the American Academy of Dermatology. The survey included a vignette that described and visually depicted a 50-year-old person with severe psoriasis followed by questions that assessed the dermatologist’s confidence in the diagnosis of psoriasis and first line treatment recommendation. Each dermatologist received one of eight survey options that differed only by either patient race (White vs Black), gender (male vs female), or socioeconomic status (high vs low). We performed multivariable logistic regression to evaluate the associations among patient characteristics and the dermatologist’s confidence in psoriasis diagnosis and treatment recommendation. The survey response rate was 19.9% (N=668). Dermatologists who received the Black patient vignette were less likely to be confident in the diagnosis of psoriasis compared to those who received the White patient vignette (odds ratio [OR] 0.15, 95% confidence interval [CI] 0.08-0.29). Diagnostic uncertainty was associated with lower odds of recommending appropriate treatment for severe psoriasis with phototherapy, oral systemics, or biologics (OR 0.33, 95% CI 0.16-0.66), independent of other patient and dermatologist characteristics. Our findings identify greater uncertainty among dermatologists in diagnosing psoriasis among Black patients compared to White patients. This diagnostic uncertainty may, in turn, contribute to existing racial disparities in psoriasis treatment and disproportionate undertreatment among Black patients with psoriasis.