Rhonda’s psoriasis first appeared when she was a teenager and during the ensuing years, she’s had pretty much every type of psoriasis there is—plaque, guttate, inverse, pustular, and psoriatic arthritis. For the first ten years or so, she didn’t know what was wrong with her skin. 
Every doctor she saw suggested something different, everything from folliculitis (an inflammation of the hair follicles) to measles. When Rhonda was in her late 20’s, one of her doctors noticed pits in her fingernails, a characteristic symptom of psoriasis and psoriatic arthritis, and finally she received a correct diagnosis.
As for treatment, Rhonda uses a variety of topical medications and she is seriously considering a trial of one of the biologics, but her preferred treatments, by far, are trips to the Dead Sea. For centuries, people with psoriasis and other skin conditions have traveled to the Dead Sea, which is known for its healing properties. Located in the Middle East it is the lowest point on Earth at 1200 feet below sea level. The sunlight there has a unique quality that alleviates psoriasis symptoms without causing sunburn. Plus, the Dead Sea itself, with its high salt and mineral content, is a comfort to swollen arthritic joints and may have a beneficial effect on the skin as well. After 2 to 3 weeks of lying out in the sun for up to 8 hours a day, Rhonda’s psoriasis, which she normally describes as severe, clears up almost completely. Rhonda tries to go there every eighteen months and would likely go more often were it not for the hefty price tag—about $4000 per trip—that she must pay entirely out of her own pocket. Dead Sea therapy has had social benefits for Rhonda as well. She has met people from all over the world there and has made many friends.
Rhonda's chosen profession, sales, doesn't permit her to keep her psoriasis a secret. Her job requires face-to-face meetings with potential customers who don't know her and don't necessarily understand her condition. 
It's tough, she says, to give a presentation and know that her audience is staring at her skin instead of listening to her ideas. She worries that some might hesitate to do business with her because they mistakenly believe that psoriasis is contagious. Travel, a frequent requirement of Rhonda’s work, is extra challenging for her. Airplanes make her skin worse, she says, and travel to Northern cities during the cold season intensifies her arthritis. She tries to conceal her psoriasis as much as possible during professional meetings, but when she can’t she forestalls any speculation by bringing psoriasis into the conversation herself. For example, if she has traveled to a new city for a meeting she might say, “I have a friend who is in one of my psoriasis groups that lives here.”
Psoriasis has had a huge impact on Rhonda’s personal life as well. “I’m 41 years old and still single,” she says. “It’s difficult going on dates, since I feel obligated to tell people I have psoriasis. It also affects whether or not I have children.” She has had some men “freak out” when she tried to explain her condition. At times, she has gravitated toward dating people with psoriasis. “There’s a comfort zone there,” she says. She has mixed feelings about having children. She knows that psoriasis is often hereditary; both her parents have it, albeit much more mildly then she does. A few people close to her have urged her not to have children because of the risk that they would inherit psoriasis. But because she may still have children, she has so far declined to try psoriasis therapies that might be unsafe during pregnancy, even though, as a result, her psoriasis may not be as well controlled as it could be.
Then there are the countless other ways in which psoriasis has intruded into Rhonda’s life. When choosing a car, she considers how easy it will be to climb into and out of when her joints ache from psoriatic arthritis. She opts for lighter colored interiors that camouflage the skin flakes her psoriasis plaques leave behind. When she wanted to put new flooring in her home, she chose the color scheme with flaking in mind. 
Northern climates are off limits for her because the cold is hard on her joints. As for vacation, short of the Dead Sea, "no pools or beaches for me," she says.
Despite all of the obstacles that psoriasis has thrown onto Rhonda’s path, she hasn’t lost her self-confidence or her optimism. She often copes by visualizing how she feels when her psoriasis is in remission. “You just can’t let it defeat you,” she says. “I may have psoriasis, but it doesn’t have me!”
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