Psoriasis is a chronic immune-mediated disease. In severe cases, there is a correlation with the rate of many comorbidities, such as psoriatic arthritis, metabolic syndrome, and inflammatory diseases of the gastrointestinal tract. Certain oncological risks are reported in the literature; however, the data are conflicting and require further research. Current foreign and Russian guidelines for moderate and severe psoriasis recommend systemic immunosuppressive therapy and targeted and genetically engineered biologic drugs (GIBD). Of particular interest is choosing the management strategy and selecting therapy in concomitant conditions due to the lack of studies on treatment safety in comorbid patients, especially ones with malignancies. This article is a literature review on the issue. Currently, we do not have complete information about the risks of using GIBD in patients with malignancies. Also, psoriasis itself can be a risk factor for tumors such as squamous cell carcinoma, colorectal cancer, and lymphoma. Therefore, the priority goal of future prospective studies should be to analyze the increase in this risk when using biological therapy compared with patients receiving traditional therapy and the control group. Considering the need to expand the real-world data on the possible risks of managing patients with severe psoriasis, we describe our clinical experience with a GIBD, interleukin-17A inhibitor, in a patient with a history of bladder cancer.