"Just go to the doctor dear,

he'll give you a cream that will clear that right up. It's silly to walk around with something that ugly on your hands (or legs, or elbows, etc...)."

How many of you have heard that statement or something like that more often than you care to count? If you're a sufferer of psoriasis you've probably taken to covering yourself from toe to chin just to avoid listening to yet another bit of advice from someone who has never had to deal with the problem, or who had a very light case that cleared up right away, and has no real idea of what they are talking about.

To the person that was lucky enough to experience a complete remission with that one time cream treatment, I say be happy that you were so blessed and be more understanding of those who have not been.

To those of you who are still hiding under layers of cloth for fear of offending someone with the appearance of the plaque lesions on your skin, my niece Sarah has something to say. "Buck up! Stop letting others make you feel self conscious because they think you are not putting forth the effort to rid yourself of what they view as basically a bad case of dandruff or a minor rash. Be yourself. Show your body if you want. If you shackle yourself in one part of your life, how can you expect to feel free and successful in the rest. Your confidence will win out over the minor imperfections in your appearance."

And, even though I do not have psoriasis, I must admit I agree with Sarah. My beautiful niece has dealt with plaque psoriasis since she was 18. I admire her courage and her lack of self consciousness. I asked her once what she does when someone comments on or asks her about the lesions, she aimed her light grey eyes right at my blue, smiled and said, "I tell them the truth". When they ask me if that's a burn or just straight out 'what is that', I tell them that they are psoriasis lesions, but not to worry because they don't hurt or itch, and they aren't contageous and that there is no cure yet." That usually works for her, but if she is outdoors and more explanation is needed, she simply adds that sun and exercise are good for the healing process, which it turns out is quite true.

Sarah's example is easier to admire from a distance than to follow. For many it is not the psoriasis itself that does the most damage to their well being, but rather the psychological impact it has on their lives. Still, Sarah is correct in her attitude, and in her statement that there is no cure YET. Yes, place the emphasis on the yet. Every day research comes a step closer to unraveling the secret to this disease.

Yes, psoriasis is a disease, not a rash. It is a disease of the immune system, or as better defined by the National Psoriasis Foundation--Psoriasis is a noncontagious, genetic disease that results when faulty signals in the immune system prompt skin cells to regenerate too quickly, causing red, scaly lesions that can crack and bleed. It often affects the elbows, knees, scalp and torso but can appear anywhere on the body. As many as 7.5 million Americans have psoriasis, according to the National Institutes of Health. Ten percent to 30 percent of people with psoriasis also develop psoriatic arthritis, an inflammatory disease which causes pain, stiffness and swelling in and around the joints. Psoriasis can affect anyone at any age, including children. There is no cure yet for this lifelong disease.

Sarah considers herself to be among the lucky few for whom the disease may just suddenly go away. She was in remission for nearly a year, until last week when she had a flare up. Flare ups can be very painful, or they can just be itchy, with lesions cracking, bleeding and peeling. Sarah is still hopeful though, even after this last disappointment. "It was just a small flare," she says, her smile lighting up the room. "The lesions are fewer, smaller, and healing faster than usual. I think it was just a minor hiccup before full remission takes hold."

For Sarah's sake, I hope that is the case. She is not sitting back and praying for a cure. She is living her life, confident in the fact that someday there will be a cure, but not letting her affliction handicap her in the mean time.