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    Read the stories of ASCP Patient Champions Rex and learn about
    the role of laboratory testing in the diagnosis and treatment of Psoriasis.

What is Psoriasis?

Psoriasis is a type of autoimmune disease, which means that the immune system attacks the body instead of protecting it. Psoriasis affects how skin cells grow. Normally, it takes a full month for a skin cell to grow and fall off (shed). With psoriasis, skin cells grow in only three or four days, but instead of falling off, they pile up on the surface of the skin. This can cause itchy and scaly patches called plaques. Plaques can appear anywhere, but they commonly affect the knees, elbows, trunk, and scalp. Psoriasis is a long term (chronic) condition and has no cure, but it can be managed with medication.


What is Psoriatic Arthritis?

Psoriatic arthritis is a joint condition that causes swelling, stiffness, and pain in the joints. 1 in 3 people with psoriasis will develop psoriatic arthritis, usually 10 years after psoriasis begins. Symptoms include fatigue, tendon pain, join stiffness, and swollen fingers and toes.



Educational Materials: Psoriasis



This high-power view of the skin from a patient with psoriasis shows thickening of the epidermis (the outermost layer of skin - blue arrow) with a thickened layer of sloughing skin cells (stratum corneum) on the very top of the image called "parakeratosis" (red arrow). Inflammatory cells are present in the deeper layer of the skin (dermis), the epidermis, and the stratum corneum.

Rex's Story

When Rex was in high school in the Philippines, he noticed a small white patch on his finger and thought he had a common fungal infection. When topical creams did not clear up the discoloration, he went to his doctor to see what could be done. After closely examining his skin, the doctor diagnosed him with an autoimmune condition called vitiligo. Vitiligo causes the skin to lose color, leaving lighter patches of skin. Skin color is determined by the presence of a substance called melanin. Vitiligo develops when the cells that produce melanin (called melanocytes) die or stop working.

As he aged, Rex’s condition progressed, and he lost more skin pigment. As a teenager, he felt isolated and alone -- he was often bullied for his appearance and had no role models.

“It was difficult during my teens, in the midst of other changes happening to my body, mind and emotions. The people around me didn’t understand or respond sensitively to what was happening.”

Though he felt isolated, Rex continued to study science and medicine to pursue a career in laboratory medicine. He now works as a Laboratory Administrative Director and is responsible for the administrative, financial, and technical management of a clinical laboratory. He is an active antibullying advocate who works to bring awareness of vitiligo to people and especially children around the world.

“My advice to others living with vitiligo is to embrace resilience and don’t listen to what other people have to say. Always remind yourself that we are unique, we are special, we are wonderfully made, and it is okay to be different.”

People with vitiligo are at a higher risk of developing other autoimmune conditions. In his twenties, Rex started showing signs of psoriasis, another autoimmune disease that affects the skin. The most common symptom of psoriasis is developing itchy, scaly rashes, though it can cause other conditions like psoriatic arthritis. Psoriasis treatment is highly individualized, so Rex had to try many different medications to find one that successfully controls his psoriasis. Many psoriasis medications work by suppressing the immune system, which puts patients at a higher risk of infection. They also can negatively affect organ function. To monitor the effects of his medications, Rex gets routine blood tests to confirm everything is working correctly.

"The lab guides me and lets me know if I am on the right track for my treatment. Lab tests provide general information about our organs and body systems and give me an assurance that, internally, I’m okay."



In 2020, when the COVID-19 Pandemic began, the essential job of laboratory management was put on full display. Rex was working long hours to make sure that his community had access to safe and reliable lab testing to diagnose COVID-19.

The long hours and continuous hard work began to wear on Rex, and his body began to shut down. One day he collapsed, and his colleagues had to wheel him to the ER. In the ER, a medical assistant took his blood pressure, and it was dangerously high. After being diagnosed with hypertension, Rex’s doctor prescribed him medication to manage his blood pressure. Like his psoriasis medication, Rex’s blood pressure medicine requires frequent routine blood tests to monitor possible side effects.

As a laboratory professional, Rex has always been proud of the work done by the lab, but being a patient has given him a unique perspective on the lab, “I have a greater appreciation of the service my colleagues do for our patients and the communities we serve. The lab results we provide save lives and I am proud that we make a difference.”