Treatments and dermatologists are not widely available, reports Marese McDonagh.
Louise Lamari remembers developing a rash when she was in her 20s which everyone assumed was a food allergy.
After a range of patch tests ruled out allergies, Louise waited for a year before the angry rash was finally diagnosed as psoriasis. At the age of 27, she had joined a club of over 100,000 Irish people with the little- talked about, but sometimes severely debilitating, skin condition for which there is no known cure.
Today, at 38, Louise, from Skerries, Co Dublin, is moving around with the aid of a walking frame. There are days when getting out of bed is a major physical test. In a poignant reversal of roles, her two children, aged seven and nine, often help her to put on her socks and do up buttons and zips.
She has just spent three weeks in hospital and will probably be out of work for quite some time.
Louise is philosophical, hopeful about her latest treatment, which she self-injects at home, and anxious that other sufferers know that hers is a "worst case scenario".
Around 5 per cent of psoriasis sufferers develop the related psoriatic arthritis. "I have it in my toes, my ankles, my hips and my knees," she explains. Doctors have already broached the subject of a hip replacement.
Peter Cremer (47) from Longford is another psoriasis sufferer who has recently been admitted to hospital after his body dramatically started to burn up.
"This thing hit me out of the blue over two weeks ago," he says. Peter, who has lived with plaque psoriasis for years, was startled when, in the space of a week, his body became as "red as the setting sun" and he felt as if he was burning from head to toe.
The condition was diagnosed as erythroderma, a very extreme form of psoriasis. Peter's skin felt like "wood which had been drying for 40 years" and the only areas not on fire were those parts of his body already affected by plaque psoriasis.
A financial consultant with Irish Life and Permanent, he had always been a fit man who played football until the age of 41 and who enjoyed walking and swimming.
Today he can barely muster the energy to talk and he does not expect to return to work for a few weeks.
He was put on a drug called Cyclosporin which, he says, is prescribed for transplant patients. He describes it as "very high tech and with a high risk of side effects".
Dr Colin Buckey, consultant dermatologist at Waterford Regional Hospital, says that dermatology is very much the "Cinderella" of the medical service despite the fact that 2-3 per cent of the population is affected by psoriasis.
He is the only consultant dermatologist for the 420,000-strong population in the southeast.
"If the Comhairle na nOspidéal recommendations were implemented, I would have three colleagues," he points out. The same recommendations would mean a minimum of 40 dermatologists in the country, but Dr Buckley says there are now 28. There is no consultant dermatologist based in the midlands.
Dr Buckley, who treats patients with a range of skin diseases including cancer, eczema and acne, says people have to wait years to see a skin specialist if their condition is relatively minor.
"There are more days lost to work through skin disease than any other malady and yet it just isn't a priority," he says. Workers in the pharmaceutical industries, for example, or in catering simply cannot work if there is any risk of infection, he explains.
While there is no cure for psoriasis, there are several very effective treatments which "sadly a lot of people do not know about".
"Some people will be too embarassed to even go to their GP because there is a bit of a stigma attached to skin disease given the visual impact," he says.
He points out that as well as creams, tablets and drugs administered by injection under the skin, ultraviolet light treatment is an option. "It's very important to stress that we don't recommend sunbeds," says Dr Buckley.
"The light therapy is strictly controlled in hospital because of the risk of skin cancer associated with overexposure. It is not a treatment that is undertaken lightly."
While the vast majority of psoriasis sufferers will have a relatively mild form of the disease which can be controlled by medication, Dr Buckley says quality of life can be affected.
The Psoriaisis Association of Ireland has appealed to sufferers to seek medical help and not allow themselves be isolated.
Chairwoman Caroline Irwin from Co Kilkenny says after 35 years "slapping on creams" she recently learned that there was a right way and a wrong way to apply the products.
"Nobody ever told me that it was better to moisturise the crusty surface of the skin first," she says. "GPs just tell you to rub it on and it is no wonder that so many people say the creams don't help because they probably don't apply them correctly."
Caroline was nine - unusually young - when she was diagnosed. She agrees with the consensus that the condition is genetic and is probably triggered by stress .
Her parents did not have psoriasis but since Caroline was diagnosed, two of her brothers and her sister have also developed the condition.
"It is in the genes and something triggers it. It could be the menopause , bereavement , or worry about a sick relative," says Caroline.
The key message from the association is that psoriasis is not contagious.
One of the worst aspects of the condition is the reaction of other people to the itchy scaly skin. "I never knew what it was like to wear tee-shirts and I bought my first dress a year ago," says Caroline.
She met her future husband at 15 and was married at 20 but says many people find relationships difficult because they are self-conscious about the condition.
While she has been hospitalised she stresses that for most people psoriasis will mean nothing more than "a bit of itch on the elbows the knees and maybe in the scalp". Having to constantly hoover up mountains of flakes which peel away from the skin is the most inconvenient part of psoriasis for many.
Staying in a hotel and trying on clothes in a shop used to be a nightmare for Caroline because shedding skin can be like "a snowstorm".
With a new branch of the association recently established in Roscommon, Peter Cremer points out that there are no dermatologists in the Longford/Roscommon area. "There is no ultraviolet light treatment available either," says Peter. "It would not be feasible for someone like me to drive to Dublin for two minutes or less under the lights a few times a week."
Louise Lamari had 20 sessions ranging in length from three seconds to 90 seconds, under the lights last May. While it did not work for her she recommends the treatment based on other people's experience.
"The important things is to be open about psoriasis. I have always talked about it and worn short sleeves and just explained to people that it is not contagious," says Louise.
"For years I fought it and tried to hide but then acceptance came and now I live with it."
Contact Caroline Irwin, Psoriasis Association of Ireland, on 086-339 5308 or Peter Cremer, Roscommon Support Group, on 087-7767167.