Psoriasis is a chronic complicated inflammatory skin disease. Genital, nail, and scalp lesions with psoriasis are difficult-to-treat and significantly impair patients' quality of life (QOL). Deucravacitinib, a selective oral tyrosine kinase 2 (TYK2) inhibitor, may act as a novel therapeutic option that improves these challenging manifestations. A retrospective study was conducted from January 2023 and February 2024 on 70 psoriasis patients treated with deucrabacitinib 6 mg. We evaluated the achievement rates of genital physician's global assessment (genital-PGA) 0/1, PGA of fingernails (PGA-F) 0/1, scalp-specific PGA (ss-PGA) 0/1, whole-body static PGA (sPGA) 0/1, and dermatology life quality index (DLQI) 0/1 at weeks 4, 16, and 24. Deucravacitinib improved genital, nail, and scalp lesions as well as systemic eruption and QOL in patients with psoriasis. Deucravacitinib may act as a promising treatment option for these difficult-to-treat lesions with psoriasis.