Eric Rummel had a promising Army career. He was ready to train for Special Forces, but then came psoriasis.
"It showed up at a very inappropriate time in my career. It caused me to leave the service," Rummel said.
It appeared as thick, dry, red patches with silvery scales, mostly on his elbows, knees and torso where clothing rubs the skin. A cut, scratch or even stress can cause a flare-up.
"There's a great deal of itching and a lot of embarassment because of the very dramatic appearance of skin lesions," said dermatologist Dr. Rebekah Oyler.
Oyler said it is a genetic condition where the skin cells reproduce too fast. Cases vary from mild to severe. Ointments and lotions help some people.
Some medications come with the risk of damage to the kidneys and liver. For moderate to severe cases, the safest treatment is phototherapy. Short doses of ultra-violet light calms the immune response of the skin which causes outbreaks.
"The light box machines are calibrated so that we know exactly how much light energy the person is receiving," Oyler said.
"The biggest concern with the light therapy is it's like the sun -- long-term exposure. You run the risk of skin cancer," Rummel said.
There is a greater risk for people with fair skin. One in 10 people with psoriasis also develop arthritis.