How Is Psoriasis Diagnosed
A healthcare provider or a dermatologist will diagnose psoriasis after a physical exam to look at your skin and review your symptoms. Theyll ask you questions that could include:
- Do you have a history of skin conditions in your biological family?
- When did you first notice symptoms?
- Have you tried any at-home remedies to treat your skin?
- Is this the first time youve had an outbreak on your skin?
- What types of soaps or shampoos do you use?
The appearance of a skin plaque leads to a psoriasis diagnosis, but symptoms can relate to other similar skin conditions, so your provider might offer a skin biopsy test to confirm your diagnosis. During this test, your provider will remove a small sample of skin tissue from your skin plaque and examine it under a microscope.
Causes Of Psoriasis And Eczema
Both eczema and psoriasis are thought to have the same cause: an immune system that kicks into overdrive and mistakenly attacks your own body. But the precise process is different for each condition.
Its different wings of the immune system, said Emily Newsom, MD, assistant clinical professor of dermatology at UCLA David Geffen School of Medicine.
In psoriasis, overproduction of certain immune-system chemicals causes the outer layer of skin cells to go through the life cycleforming then sloughing offin just days rather than a month. The result is a layer of super-fast-forming cells building up on your skin. Thats what causes the thick coating of red, silvery scales on your skin that are characteristic of plaque psoriasisthe most common type of psoriasis.
Eczema affects the ability of the skin to protect against outside irritants and allergens.
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What Causes Eczema And Psoriasis
Scientists arent sure exactly what causes eczema, but its likely genetic and triggered by allergic reactions to items like soap or fragrance, or could be onset by dry skin, Dr. Wang says. Environmental factors, like cigarette smoke, pollution and stress, could also trigger eczema, per AAD experts.
Research suggests that the immune systems in people with eczema likely overreact, causing inflammation when they come in contact with certain triggers, which makes the skin red and itchy.
Like eczema, theres no exact known cause for psoriasis, but it too has an immune system link. Psoriasis is caused by an overactive immune system that revs up the production of new skin cells. According to the National Psoriasis Foundation, skin cells typically grow and fall off within a month, but in people with psoriasis, skin cells go through this process in just a few days. Instead of falling off, the cells pile up on the skin, creating thick, scaly patches, which experts call plaques.
Clinical Significance Of Atopic Dermatitis
Atopic dermatitis is often accompanied by allergic rhinitis, asthma, and food allergy , as well as conjunctivitis . The prevalence of asthma among children with atopic dermatitis ranges from 14.2 to 52.7%, while 75% of children with severe atopic dermatitis develop allergic rhinitis . The incidence of food allergies among those with atopic dermatitis appears to be more common than in the general population, but obtaining exact figures is hampered by varying definitions adopted across studies .
Psychiatric Comorbidities and Burden of Disease
An association has been found between an increased severity of atopic dermatitis and a greater frequency of psychologic disturbances, including anxiety, depression, attention deficit hyperactivity disorder, autism, and suicidal ideation . This supports the need to effectively manage the disease in order to improve the general well-being and quality of life of patients and their families . For example, parents of children with atopic dermatitis may be affected because of the time-consuming nature of implementing treatment regimens or dietary and household changes. Also, atopic dermatitis can have a substantial financial impact on both individual families and society .
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Yes You Can Technically Have Psoriasis And Eczema At The Same Time
Experts know that psoriasis affects around 3% of adults in the United States 1 eczema is a bit more common, affecting around 7% of adults.2 Its possible to have eczema and psoriasis at the same time, but its pretty rare, according to Alexa B. Kimball, MD, MPH, a professor of dermatology and the president of Harvard Medical Faculty Physicians at Beth Israel Deaconess Medical Center. Theyre a little bit of a yin and yang, in terms of which parts of the immune system are being activated, she tells SELF. So they dont usually occur in the same people, but they can.
A 2021 paper published in the journal Skin Health and Disease reviewed the findings of 31 studies on these two conditions and found that the prevalence of them occurring together is approximately 2%. The researchers concluded that clinicians should be aware of coexistence at diagnosis and when reviewing poor response to treatment.3
Even though psoriasis and eczema might look similar, they may require different medications and therapies, so its important to see a dermatologist who can diagnose you and figure out a treatment plan thats most appropriate for your situation.
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What Are The Symptoms Of Eczema
Eczema isn’t actually one condition all its own the diagnosis refers to a group of skin conditions that cause itchiness, inflammation and rashes, according to the National Eczema Association . Your bout of eczema may include one of seven common conditions that affect more than 30 million Americans, including atopic dermatitis, contact dermatitis and others.
Atopic dermatitis is the most common form of eczema, Dr. Wang says. It usually starts in early childhood and features itchy rashes, most routinely on the face and in the soft spot behind the knees, that come and go.
Itchiness is the most common symptom of all types of eczema. Though, it affects people in different ways. Some only have mild itchiness, while others are so itchy that they scratch until their skin bleeds.
Other symptoms, according to the NEA, include:
- Dry, sensitive skin
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Seborrheic Dermatitis: Itchy Scaly Patches
A psoriasis skin rash tends to itch, burn, and feel sore. Patches of psoriasis commonly occur on your knees and elbows. Many people also have scalp psoriasis. The common skin rash seborrheic dermatitis also causes scaly, itchy skin patches. It can occur on your scalp, where it may be called dandruff, or on your face and chest. While doctors don’t know the exact cause of seborrhea, it occurs across the age spectrum, in babies as well as in adults, and is usually treated with creams and lotions.
Clinical Significance Of Psoriasis
Psoriasis has been linked with a range of physical comorbidities including: psoriatic arthritis cardiovascular disease Crohns disease chronic obstructive pulmonary disease sleep disorders kidney disease metabolic syndrome and non-alcoholic fatty liver disease .
Psychosocial and Psychiatric Comorbidities
Risk factors for a variety of psychosocial and psychiatric comorbidities appear to be higher among patients with psoriasis compared with the general population . For example, individuals may become secludedprompting depressionwhen psoriatic lesions appear, thus treatment may promote an improvement in mood partly because of an improvement in psychodynamic issues . Additionally, stress can exacerbate psoriasis, which itself is a stress-inducing disease .
Medications used to treat comorbidities may also exacerbate psoriasis in patients, potentially leading to depression, anxiety, and low self-esteem . Management of psoriasis should, therefore, incorporate a strategy to address both physical and non-physical comorbidities .
Burden of Psoriasis
The burden of psoriasis spans physical, psychologic, and social aspects. At present, psoriasis is an incurable disease that is often diagnosed before patients are aged 30 years. Consequently, individuals may live most of their adult life with a chronic, debilitating, and potentially stigmatizing illness , which may not always be acknowledged by clinicians .
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Is There A Cure For Psoriasis And Eczema
Plaque psoriasis is the most common form of the disease with red raised patches covered in silvery scales affecting my knees, elbows and forearms. After educating herself on nutrition, she then cut out caffeine, alcohol, sugar, dairy and wheat. I cleared my psoriasis, eczema and acne, and lost five stone in weight without trying.
While the exact cause of eczema and psoriasis is not known, there are many factors that can make the symptoms worse, diet being one of them. If you have eczema or psoriasis there are certain foods that can cause flare ups.
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What Are Psoriasis And Eczema Exactly
Psoriasis is an autoimmune condition that affects about 7.5 million Americans, according to the American Academy of Dermatology. It happens when your skin cells go through their life cycle more quickly than normal. Typically it takes about a month for skin cells to regenerate, but people with psoriasis, this cell-turnover process happens every three to four days, according to the Cleveland Clinic. The buildup of new skin cells results in flaky scales on the skins surface.
Eczema is much more common than psoriasis, affecting between 2 and 10% of all adults.1 Eczema causes patches of dry, itchy skin that tend to turn into a rash when you scratch or rub it. These patches are prone to bacterial, viral, and fungal infections. Thats because, at its core, eczema is tied to a gene variation that affects the skin barrier and its ability to protect your skin from everything from bacteria to irritants and allergens. Eczema flares are triggered by environmental and lifestyle factors, such as irritating skin care products, dry skin, and stress. The main symptom of eczema is itchy, flaky skin, but people who have eczema as children are more likely to develop asthma and environmental allergies.
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What Are The Differences Between Eczema And Psoriasis
The table below outlines the differences between the two commonly confused skin conditions.
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|How does it feel?||Very itchy, painful, and dry||Sometimes itchy|
|Where does it happen on the skin?||
|What are additional symptoms and risks?||
Signs And Symptoms Of Psoriasis On The Tongue
Psoriasis can cause periodic flare-ups of symptoms, after which theres little or no disease activity.
Since you can have psoriasis anywhere on your body, its also possible to have it in your mouth. This includes the:
Lesions on the tongue can vary in color, from white to yellowish-white to gray. You might not notice lesions at all, but your tongue may be red and inflamed. This usually occurs during an acute psoriasis flare-up.
For some people, there are no other symptoms, which makes it easily overlooked. For others, pain and inflammation can make it hard to chew and swallow.
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There Can Be Overlap Between Eczema And Psoriasis
Still in some children, its hard to tell the difference. In this case, a dermatologist might diagnose the child with psoriasiform dermatitis.
Sometimes, a child has both eczema and psoriasis, so there can be some overlap.
A dermatologist, however, will generally be able to differentiate between these two relatively common skin disorders.
All content solely developed by the American Academy of Dermatology
What Triggers Eczema And Psoriasis
Triggers of eczema and psoriasis may be different for each person. Here is a list of common eczema triggers:
Extreme temperature changes or weather patterns
Sweat and rubbing of the skin
Wool or other irritating clothing
Topical allergens, such as certain preservatives and fragrances
Prolonged and frequent bathing with harsh soaps
Infections and illnesses, like strep throat
Scratches, burns, and injuries to skin
Lifestyle factors like being a heavier weight and drinking alcohol
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Guttate Psoriasis: Small Red Spots
Guttate psoriasis the second most common type of psoriasis is characterized by multiple small, round red spots on the skin, usually widespread across the trunk and limbs. Often resulting from a bacterial or viral infection in children, such as strep throat, these spots come on suddenly and sometimes require oral medication or injections. Mild cases, however, may clear up without treatment.
What’s The Difference Between Eczema And Psoriasis
Children get eczema. They can also get psoriasis.
While more children develop eczema than psoriasis, almost 1% of children have psoriasis.
Its not always easy to tell whether a child has eczema or psoriasis. A study conducted in Australia found that most children who had psoriasis were initially diagnosed by their primary care doctor as having another disease, often eczema.
To a dermatologists trained eye, psoriasis and eczema tend to look quite different.
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When Should I See A Healthcare Provider For Skin Rashes
If you have skin rashes that wont go away, it is a good idea to seek help. Dermatologists are experts in eczema and psoriasis and can help you find a treatment plan that works for you.
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Eczema Vs Psoriasis: Whats Causing My Itchy Skin
If you or a loved one has patches of red, dry and itchy skin that may even come and go, you may be wondering is it eczema or psoriasis? Or are these two conditions the same thing? Theyre not. Eczema and psoriasis are two distinct skin diseases that may require different treatment plans. Thats why its important to speak to your healthcare provider to get the right diagnosis.
While they may be difficult to tell apart, a dermatologist can spot the differences between these two non-contagious and common skin conditions:
- Plaque psoriasis, the most common type of psoriasis, causes well-defined, thick, silvery-white scaly patches, commonly found on areas like the elbows, knees, the scalp and lower back.
- Atopic dermatitis, the most common form of eczema, may look slightly different in children and adults. Eczema is typically very itchy in all who are affected. In children, it appears as a dry or scaly, red rash, often in the creases of the elbows or knees. Adults tend to have patches of thicker or more chronic scaly skin rashes in similar areas as children, but are most noticeable on the face or hands.
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Inflammatory Skin Conditions: Eczema Seborrheic Dermatitis And Psoriasis
The flaking and itchy skin caused by eczema, seborrheic dermatitis, and psoriasis can be very uncomfortable and often leads to feeling self-conscious or alone during flare-ups. Fortunately, there is much you can do to tame these inflammatory skin conditions. It may take some trial and error, but chances are that you will find a strategy that works for you. This guide will help you understand your options. Youll learn about what causes these skin conditions typical symptoms of each how these conditions are diagnosed and treated and what you can do on your own to manage them.
Why Are Eczema And Psoriasis Sometimes Mistaken For Each Other
Eczema may sometimes be mistaken for psoriasis because it causes a painful, itchy rash that may even appear raised. To the untrained eye , this might make an eczema patch look like a psoriasis plaque.
Psoriasis and eczema arent likely to be confused by a trained dermatologist, though, Azeen Sadeghian, MD, FAAD a board-certified dermatologist in Baton Rouge, Louisiana, tells SELF. But she notes that there are some exceptions. Some cases are challenging because the eczema patches have become thickened enough to resemble psoriasis, she says. Experts call this thickening lichenification.
Its tempting to think of eczema as psoriasis light, which will eventually worsen and become psoriasis. But eczema will not develop into psoriasis. They are two separate conditions, with separate underlying causes. However, it is possible to have both eczema and psoriasis. This condition is called eczematous psoriasis, sometimes known as PsE, according to a 2015 study published in the Journal of Clinical Medicine.2
The National Psoriasis Foundation notes that a delay in diagnosis can mean people with darker skin tones arent able to take advantage of early treatment options. Research is still underway to understand how to best identify psoriasis in people with darker skin tones.
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Treatment Of Psoriasis Vs Eczema
Both psoriasis and eczema are treated by modulating the immune system. Topical corticosteroids are commonly used to treat both conditions since both lead to inflammation of the skin. The effects of topical medications are mostly limited to the skin.
Keeping skin moisturized can help control eczema. In severe cases of eczema, it may be necessary to take systemic oral medications such as Methotrexate or Mycophenolate mofetil. More recently, the biologic Dupixent has been developed. Itâs an injection given twice each month to control the inflammation.
Since psoriasis is a chronic autoimmune disease that can cause systemic symptoms and progressive joint damage, it is important to calm the immune system throughout the body to control inflammation and reduce autoimmune attacks on the skin and joints. Systemic treatment options for psoriasis include immunomodulators, such as Methotrexate, and newer biologic drugs, such as Enbrel , Humira , and Stelara , which are injected into the skin. There are more than 10 biologic medications that target the pathways associated with psoriasis. Phototherapy, or light therapy, may also be helpful in some cases of psoriasis. Read more about psoriasis treatments.