Several guidelines recommend phototherapy, systemic agents, or biologic therapy for the treatment of moderate-to-severe psoriasis. Sequential use of more than 1 biologic has become more common due to primary or secondary failure with this type of treatment and an increase in the number of drugs available. However, the order of usage of these drugs is still speculative. We report about a patient with severe psoriasis with primary failure to respond after treatment with ustekinumab and adalimumab who achieved psoriasis area and severity index (PASI) 100 score with secukinumab in 8 weeks. Case PresentationA 47-year-old woman presented with a 30-year history of psoriasis vulgaris without psoriatic arthritis or other comorbidities. She was previously treated with methotrexate and PUVA but had hepatotoxicity and minimal response with UVB narrowband.At first visit, the patient revealed PASI 23.7, dermatology life quality index (DLQI) 30, body surface area (BSA) 30, and body weight 80 kg (Figure 1) and was subsequently