Is Kim Kardashian Acting Rashly?

In tonight’s  new episode of Keeping Up with the Kardashians, Kim goes to her dermatologist, Dr Harold A. Lancer, to have him look at a rash on her legs. He diagnoses her as having psoriasis, a skin condition that her mother, Kris Jenner, has had for many years. The doctor explains that the disease is influenced by many things, such as “stress, food, water, diet. Travel has a lot to do with it” and suggests that she “lead an easier, slower paced life.” Dr. Lancer finally tells her that although there is no “cure” for the condition, it can be controlled.

This puts Kim into an immediate tailspin. As she puts it:

My career is doing ad campaigns and photo shoots. People don’t understand the pressure on me to be perfect.

Leading a slower paced life without a lot of travel for Kim is “just not possible”!

Calm down Kim. Psoriasis is not the end of the world. There are many treatment options for you (see below). And besides, haven’t you ever heard of Photoshop?

Psoriasis is a skin disease that causes itchy or sore patches of thick, red skin with silvery scales. You usually get them on your elbows, knees, scalp, back, face, palms and feet, but they can show up on other parts of your body. Psoriasis is fairly common; it affects greater than 3 percent of the United States population, or more than 5 million adults.

About 30 percent of those with psoriasis experience joint inflammation that produces symptoms of arthritis. This condition is called psoriatic arthritis. Pro-golfer Phil Mickelson was diagnosed with psoriatic arthritis about a year ago.

Psoriasis is caused by a problem in the immune system. In a process called cell turnover, skin cells that grow deep in your skin rise to the surface. Normally, this takes a month. In psoriasis, it happens in just days because the cells rise too fast.

People with psoriasis may notice that there are times when their skin worsens, called flares, then improves. Conditions that may cause flares include infections, stress, and changes in climate that dry the skin. Also, certain medicines, including beta-blockers, which are prescribed for high blood pressure, and lithium may trigger an outbreak or worsen the disease.

Doctors use a 3-step approach to treat psoriasis:

  1. Medicines are applied to the skin (topical treatment). Ointments or creams applied directly to the skin. These include corticosteroids, vitamin D3, retinoids, coal tar or anthralin.
  2. Light treatments (phototherapy). Both natural light from the sun and artificial ultraviolet light can reduce symptoms. Light therapy should be administered by a doctor, since spending time in the sun or a tanning bed can cause skin damage and increase the risk of skin cancer. Frequently topical treatment is combined with light treatment.
  3. Taking medicines by mouth or injection that treat the whole immune system (called systemic therapy).

Since discovering that inflammation in psoriasis is triggered by  a specific kind of immune cell called T cells, researchers have been studying new treatments that quiet immune system reactions in the skin. Among these are treatments that block the activity of T cells or block cytokines (proteins that promote inflammation).

For more information about psoriasis, click here to go to the Resounding Health Casebook on the topic.

I’m sure some of you have experience with psoriasis.

  • How do you deal with it?
  • How has it changed your lifestyle?


Michele R. Berman, M.D. was Clinical Director of The Pediatric Center, a private practice on Capitol Hill in Washington, D.C. from 1988-2000, and was named Outstanding Washington Physician by Washingtonian Magazine in 1999. She was a medical internet pioneer having established one of the first medical practice websites in 1997. Dr. Berman also authored a monthly column for Washington Parent Magazine.


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