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Psoriasis is a long-lasting autoimmune disease which is characterized by patches of abnormal skin. These skin patches are typically red, itchy, and scaly. They may vary in severity from small and localized to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.
You cannot catch psoriasis from another person. The main goal of treatment is to stop the skin cells from growing so quickly.
Eczema is a form of dermatitis, or inflammation of the upper layers of the skin. The most common type of eczema is called atopic dermatitis. It often occurs in people who have allergies or asthma. It is not infectious.
Causes
Eczema
Sometimes the cause of eczema is unknown. However, people with eczema have sensitive skin and are prone to developing allergies to certain substances which can cause flare-ups of eczema. These substances include things like soaps, detergents, shampoos, perfumes, wool, dust mites and other allergens.
Psoriasis
Psoriasis is a common skin condition that causes cells to build up rapidly on the surface of the skin. The extra skin cells form thick, silvery scales and itchy, dry, red patches that are sometimes painful. Psoriasis is a chronic disease that often comes and goes.
The cause of psoriasis is unknown, however it is believed to have a genetic component. There is no cure for psoriasis. Treatments can help reduce inflammation and scale, slow the growth of skin cells, and remove plaques.
Prevalence
Eczema
Eczema is a highly prevalent and burdensome skin condition globally. The overall worldwide prevalence of eczema in adults range from 1% to 3% but recent studies including the United States show a higher prevalence of 7.2%. In Singapore, the National Skin Centre conducted a cross-sectional population-based survey of 3400 adults aged between 18 to 69 years old. The study found that 13.1% of these adults have eczema. The mean age of onset of eczema is approximately 6 months, with most (80%) developing the condition before 5 years of age.
Psoriasis
Global
The prevalence of psoriasis varies with geographic location. In general, the rates are higher in Caucasians than in Asians or African Americans. The US National Psoriasis Foundation (NPF) estimates that 7.5 million Americans have psoriasis, about 3.6% of the population.
Europe
In a study conducted by the European Academy of Dermatology and Venereology (EADV) on the epidemiology of psoriasis in Europe, it was found that 2-4% of Europeans had psoriasis. The prevalence of psoriasis has been reported to be 0.1% in rural areas and 1% in urban areas, with a female-to-male ratio of 1:1 to 3:1. The highest incidence was found in Denmark and Sweden, where it affects up to 4% of the population.
Symptoms
Eczema
The following are common symptoms of eczema:
- Itching (sometimes severe)
- Red rash or patches of skin
- Dark colored patches of skin (especially in people with dark complexions)
- Areas of swelling or puffiness
- Dry skin that may crack or flake
- Leathery areas of skin as a result of scratching and rubbing
- Scaly skin
- Oozing blisters
Psoriasis
Symptoms of psoriasis vary from person to person. They may include:
- Red patches of skin covered with thick, silvery scales
- Small scaling spots (commonly seen in children)
- Dry, cracked skin that may bleed
- Itching, burning or soreness
- Thickened, pitted or ridged nails
- Swollen and stiff joints
Diagnosis
Eczema
Skin biopsy: Skin biopsies are performed to exclude other diseases and confirm the diagnosis. Many types of eczema have a characteristic appearance; however, if the diagnosis is uncertain, a skin biopsy may be necessary.
Blood tests: These are done to exclude other diseases, including autoimmune diseases (conditions that affect your immune system), allergies, and infection.
Patch testing: Patch testing is used to identify allergic causes of eczema. During patch testing, small amounts of suspected allergens are applied to the skin on patches. The patches are placed on the back and removed after two days. If a rash appears at the site of a particular allergen, it suggests that you might be allergic to that substance.
Psoriasis
Diagnosis of psoriasis is clinical, and the type of psoriasis present affects the physical examination findings.
For plaque psoriasis (the most common type), the physical examination findings may include the following:
Plaques with a silvery white scale; the scale may be fine or thick
Red, inflamed skin without scales (this type of psoriasis is called erythrodermic psoriasis)
Well-defined, red, scaly plaques that itch or burn (these are characteristic lesions of plaque psoriasis)
Psoriatic arthritis can be difficult to diagnose because its symptoms mimic those of rheumatoid arthritis and other autoimmune diseases.
For pustular psoriasis, the physical examination findings may include the following:
Scattered pustules on a background of red skin (in general pustular psoriasis)
Pustules on palms and soles with fever and severe itching (in palmoplantar pustulosis)
For guttate psoriasis, the physical examination findings may include the following:
Small, pink-red papules with a fine scale on trunk, limbs, and scalp.
Treatments
Eczema
Apply the cream or ointment after bathing, when your skin is still damp. This will help keep your skin moist.
Short, lukewarm baths or showers are best because they cleanse the skin without drying it out too much.
To reduce itching and irritation, add 1 cup of uncooked oatmeal or a handful of baking soda to your bath water.
After bathing, gently pat your skin dry with a soft towel (rather than rubbing) and apply moisturizer all over while your skin is still damp.
For severe eczema, your doctor may prescribe an oral antihistamine or corticosteroid medication (orally or by injection). These medications can cause side effects, such as drowsiness and weight gain, so they’re used sparingly and for short periods of time.
Psoriasis
The goal of psoriasis treatment is to stop the skin cells from growing so quickly, reduce inflammation and relieve itching.
Psoriasis treatments fall into three categories:
Topical treatments. These are creams and ointments you apply to your skin. They include prescription products and shampoos as well as over-the-counter moisturizers, foams and creams that contain coal tar or salicylic acid to help reduce scaling.
Light therapy. This involves exposing your skin to ultraviolet light under medical supervision. Light therapy can be administered in a doctor’s office or with a light box at home.
Oral or injected medications. These drugs, which include methotrexate (Trexall) and cyclosporine, affect the immune system and may be used if you have severe psoriasis that doesn’t respond to other treatments. Newer medications include Otezla (apremilast), a pill that targets inflammation in the body caused by psoriatic arthritis, and Cosentyx (secukinumab), an injectable medication that targets interleukin-17A, a protein involved in inflammation that’s linked to psoriasis.
Risk factors
Eczema
When you have eczema, your skin is more sensitive than other people’s skin. That means you’re more likely to react to something that bothers their skin only a little or not at all.
Experts don’t know exactly what causes eczema, but they do know that it runs in families. You may be more likely to get it if someone in your family has it, allergies, or asthma.
Eczema doesn’t have just one cause. It seems to happen when your body’s defense (immune) system overreacts to something that wouldn’t bother most people. Your skin may get red and itchy when it comes into contact with:
- Soaps, detergents, shampoos, and disinfectants
- Dust and animal dander
- Grass and pollen
- Cigarette smoke and other types of smoke, including wood smoke
- Cold weather that makes your skin dry
- Certain foods, such as dairy products, eggs, soy products, wheat, fish, and nuts
Psoriasis
Family history: People who have a family member with psoriasis are more likely to develop the disease.
Age: Psoriasis commonly appears between the ages of 15 and 30, but it can occur at any time.
Stress: Many people have found that stress triggers their psoriasis symptoms.
Infections: Throat infections caused by strep bacteria are linked to guttate psoriasis, which causes small spots of redness on the skin.
Smoking: Smoking can increase your risk of developing psoriasis.
Obesity: People who are obese are more likely to develop severe cases of psoriasis.
Prevention
Eczema
Prevention for eczema includes:
- Moisturize often. You can hydrate your skin with lotions or creams, or you can also use petroleum jelly to seal in moisture.
- Oatmeal baths. Oatmeal is a natural cleanser that helps remove irritants from your skin and restore its protective barrier.
- Avoid triggers. Know what triggers your eczema symptoms and try to avoid those triggers as much as possible
Psoriasis
Follow these tips to help prevent new plaques of psoriasis:
- Use moisturizers or creams to keep the skin moist and soft.
- Cleanse gently but thoroughly. Avoid harsh soaps and scrubbing pads.
- Avoid skin injuries, including bruises and cuts.
- Quit smoking, if you smoke.
When to see a doctor for psoriasis or eczema?
If you have psoriasis or eczema, you know how bothersome it can be. Unfortunately, there isn’t a cure for psoriasis or eczema. There are medications that can help relieve the symptoms and slow the progression of the condition, but they are not perfect and often have side effects.
If you have psoriasis or eczemia, see your doctor if:
- You’re experiencing intense itching
- You have pain in your skin
- You’re noticing that your skin is getting worse and not better
- You’re having difficulty sleeping because of your condition
- Your condition is affecting your mood