“Stephanie, you appear to have psoriasis, which is an autoimmune disorder that affects the skin,” says Dr. Shelby. “Basically, you’re having an inflammatory response in your skin that is causing cells in your epidermis to overproduce skin cells. That creates these plaques on your skin.”

“Autoimmune what?” asks Stephanie. “What’s that? Why is that happening? And can you fix it?”

Questions:

1. What cells in the skin are primarily responsible for signaling the immune system? What kind of response do they trigger in the skin?

2. What is an autoimmune disease?

3. How will Dr. Shelby likely treat Stephanie’s problem? And what is her prognosis if she follows this treatment?

“I’m having another problem too…” says Stephanie hesitantly. “I’ve been feeling pain in other areas too…my knees and elbows especially are aching. They hurt pretty often, and I feel kind of tired.”

Dr. Shelby examines her hands, which appear normal, and asks, “Is it only your elbows and knees? No other joints hurt in your body?”

“No, it’s just those,” answers Stephanie.

Questions:

4. What would be your diagnosis for Stephanie at this point?

5. There are five types of this particular disease. Which one does Stephanie have, and how do you know?