Psoriasis is a chronic, complicated inflammatory skin disease. Genital, nail and scalp lesions with psoriasis are difficult to treat and can considerably impair patients' quality of life (QoL). Deucravacitinib, an oral selective tyrosine kinase 2 inhibitor, may represent a novel therapeutic option that could improve these challenging manifestations. To investigate this, we conducted a retrospective study between January 2023 and February 2024, involving 70 patients with psoriasis treated with deucravacitinib 6 mg orally once daily for 24 weeks. We evaluated how many patients achieved a static Physician's Global Assessment (PGA) of Genitalia (sPGA-GTM) score of clear/almost clear (0/1), PGA of Fingernail Psoriasis (PGA-F) 0/1, scalp-specific PGA (ss-PGA) 0/1, static PGA (sPGA) 0/1 and Dermatology Life Quality Index 0/1 at weeks 4, 16 and 24. We also assessed the Psoriasis Area and Severity Index scores. Deucravacitinib improved genital, nail and scalp lesions, as well as systemic eruption and QoL in patients with psoriasis. Deucravacitinib may be a promising treatment option for lesions in difficult-to-treat areas in patients with psoriasis.