by | Apr 12, 2024 | Family Health
How Can I Know If I Have Psoriasis or Eczema?
Itching skin is simply annoying, and angry-looking skin can be an embarrassment. Unfortunately, you have recently found yourself dealing with both. Your sleep is suffering, your mood has certainly soured, and your overall quality of life has plummeted. You just can’t find relief no matter what you do. You’ve got summer adventures planned and sitting around feeling miserable isn’t an option.
Itching and angry skin can signal psoriasis or eczema, but how can you know if you are dealing with either one? And if you do have one, how can you know which one? Factoring into each is an overactive immune response and heredity. Although these skin issues share symptoms such as discolored skin and the appearance of a rash, they have differences. The untrained eye has difficulty reliably distinguishing between them and in rare cases, a person can have both. Neither is contagious but stress and other outside factors can trigger both.
What is Psoriasis?
In psoriasis, the immune system secretes inflammatory markers causing skin cells to overgrow and shed every 7 days vs. the normal 21 days. As a result, the cells pile up creating a thickened skin surface that is scaley, dry, and painful. Psoriasis commonly shows up between the ages of 15 and 35. Older adults around age 60 may also see a re-emergence of symptoms. In the U.S., about 3% of adults have psoriasis as compared to only 1% of children. Psoriasis is a chronic immune disease characterized by systemic inflammation of the skin and other organs and is associated with diseases such as Type 2 Diabetes, cardiovascular disease, anxiety, and depression. Family genetics, environmental factors, and certain medications all have roles in the development of psoriasis. Seeking medical treatment is important for access to prescription medications that can treat both the skin and joints helping to minimize psoriatic arthritis damage to the joints.
Psoriasis Symptoms:
- Red plaques with silvery scales on lighter skin, purplish or discolored skin on skin of color
- Usually appears on elbows, kneecaps, upper buttocks, fingernails, hands, and the scalp, but can also cover the entire body.
- Skin is more inflamed than with eczema.
- May be itchy or not.
Psoriasis plaques are typically thick and raised with very defined borders. They often appear on the trunk of the body, knees, and elbows, but they can also appear on the scalp or at the hairline. It is important to note that on lighter skin psoriasis on the palms of the hands, the scalp, or in the folds of skin may have plaques that appear red smooth, and shiny with less distinct edges as compared to the usual thick and silverly scales making them easy to confuse with eczema.
What is Eczema?
The term ‘eczema’ describes a group of conditions that cause a rash-like appearance and inflamed itchy skin. Normally, the skin acts as a protective barrier controlling what moves into and out of the body. Researchers have found those with eczema often have overly reactive immune systems. When the immune system releases inflammatory markers to the skin, the skin gives in to inflammation and breaks down causing red, weepy, and itchy skin. In some eczema patients, a gene responsible for the protective layer on top of the skin has mutated leaving the skin weakened—vulnerable to dryness, contaminants, and more prone to flare-ups and infection.
There are seven types of eczema: atopic dermatitis, contact dermatitis, dyshidrotic eczema, nummular eczema, seborrheic dermatitis, and stasis dermatitis. Eczema is four times more common than psoriasis with the most ordinary form of eczema, atopic dermatitis, often occurring in babies and children along with hay fever and asthma. These three conditions are called the “atopic triad.” Eczema affects more than 9.6 million children and 16.5 million adults.
Eczema Symptoms:
- Dry patches, bumps, or fluid-filled blisters on the skin
- Lighter skin- Patches of dry red bumpy skin with less defined borders than plaque psoriasis
- Darker skin tones- patches of darker brown, grey, or purple with swelling and dryness
- Eczema is called “the itch that rashes” due to its very intense itch.
- If you have begun treatment for eczema with a topical cream or a biologic (a drug targeting only a specific part of the immune system) and find that your rash gets worse or becomes more defined, you may have psoriasis.
Differences Between Psoriasis and Eczema
The biggest difference between the two diseases is their causes. Psoriasis is the result of an underlying immune system dysfunction causing skin cells to grow too fast. The causes of eczema are more complicated to identify with both environmental and genetic factors at play.
Both conditions cause itching and otherwise uncomfortable skin. Eczema causes dry skin with an intense itch, whereas psoriasis produces more of a burning or stinging sensation—if there is an itch, it tends to be mild.
One way to differentiate between eczema and psoriasis relates to where on the body the affected skin appears. Eczema tends to occur on flexural skin surfaces, or the skin on the inside of a bendy part such as the back of the knee. Psoriasis tends to show up on extensor skin surfaces, or the outside of bendy parts like the kneecap. Eczema and psoriasis can both affect the feet, but the involvement of the soles of the feet usually points to psoriasis. A single test cannot diagnose either disease. Diagnosis is typically based on a physical exam and review of symptoms.
Are Treatments Similar?
Eczema and psoriasis share similar treatments including:
- Over-the-counter medications: Aimed at relieving symptoms or preventing infection.
- Topicals: Prescribed medications applied on the affected skin.
- Phototherapy: Light therapy that uses a machine under medical supervision to create UVB light to reduce itch and inflammation, while boosting the skin’s bacteria-fighting.
- Biologics: Medications that target the inflammation-causing protein, usually given by injection or intravenous (IV) infusion.
- Systemics: Oral medications that control immune system response and reduce inflammation in severe cases.
There is no prevention of Eczema and psoriasis, but you can take steps to lessen flare-ups:
- Moisturize: Keep skin moist with lotions or creams
- Soaps: Use mild soaps and detergents
- Avoid known triggers: alcohol, skin injuries and infection, dry skin, certain medications
- Sun: Avoid excessive exposure to the sun and skip tanning beds
- Stress: Manage your stress through diet, exercise, meditation
Itchy and uncomfortable skin can point to diseases besides psoriasis or eczema. Conditions including scabies, herpes, and mycosis can be confused for either disease. To protect your overall health, it is important to consult with a doctor for an accurate diagnosis and treatment plan.
Let AFC Urgent Care Farragut be your trusted medical center in Knoxville, with our convenient, compassionate, and professional care always at the ready.
