Use of botulinum neurotoxin A (BoNTA) for treating inflammatory skin disease is an underexplored area in medical dermatology. Preclinical mouse studies have demonstrated efficacy of abobotulinumtoxinA in improving psoriasiform skin inflammation. We describe sustained local clearance of a psoriasis plaque in a patient following a single off-label injection of intradermal abobotulinumtoxinA. BoNTA may offer a novel therapeutic approach for treating recalcitrant plaque psoriasis. Case reports and anecdotal evidence suggests that onabotulinumtoxinA may be useful for treating inverse psoriasis.1,2 We previously reported an improvement in skin phenotype in a preclinical mouse model following a single intradermal injection of abobotulinumtoxinA.3 Here we present a patient case report demonstrating efficacy of abobotulinumtoxinA in reversing plaque psoriasis.