Individuals with psoriasis may experience significant physical discomfort and some disability.   Itching and pain can interfere with basic functions, such as self-care, walking, and sleep.   Plaques on hands and feet can prevent individuals from working at certain occupations, playing some sports, and caring for family members or a home.   The frequency of medical care is costly and can interfere with an employment or school schedule.   People with moderate to severe psoriasis may feel self-conscious about their appearance and have a poor self-image that stems from fear of public rejection and psychosexual concerns.   Psychological distress can lead to significant depression and social isolation. 
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