eczema and psoriasis is a chronic skin disease. They both cause a red, dry, scaly rash. Although they share similar signs and symptoms, psoriasis and eczema have different causes. They can also have very different treatments.
If you have skin symptoms, your doctor can determine whether it’s eczema or psoriasis. They will also make sure you get the right treatment.
In this article, you will learn about the difference between two chronic skin conditions: eczema and psoriasis. Although they share common symptoms, these conditions have different causes and treatments.
Both eczema and psoriasis can cause inflamed, dry skin. Often, you will have these symptoms over and over again. These episodes are called flares.
Most people have a hard time distinguishing between the two skin conditions because they look similar. In fact, eczema and psoriasis are often misdiagnosed as each other in babies and children.
However, to a dermatologist (dermatologist), the difference between the two conditions is very clear. Here are some of the key differences between eczema and psoriasis that they will be looking for.
Both psoriasis and eczema can cause rashes on your skin, but they can appear on different parts of your body.
Eczema is also called atopic dermatitis. It most commonly occurs on the elbows and the back of the knees. These parts of the body are called curved surfaces. Psoriasis occurs more often on the outside of the forearms and elbows or the front of the knees and calves. These are the extensor surfaces of the body.
Psoriasis can also appear on your scalp, face, ears, neck, belly button, arms, legs, feet, hands, ankles, and lower back. Eczema can also occur in these areas, but not as severe as psoriasis.
Both diseases can cause ridges, discoloration, and thickening of the finger and toenails. However, only psoriasis can cause small holes (dimples) in the nails.
7 Types of Psoriasis
Both eczema and psoriasis can look like dry, red, thickened patches of skin. However, when you look closely, things are different.
Eczema causes rashes, swelling, bumps, and generalized areas of darkened, tough skin. Severe eczema can even ooze and crust over.
Psoriasis looks like well-defined patches of red skin covered with fine silvery-white scales called plaques. Plaque bleeds easily when scratched. They leave a precise pattern of blood spots (Ospitz sign).
Scaling is the main hallmark of psoriasis. If you have eczema, you can get scaly, but it doesn’t always happen.
Itching (itching) can be part of psoriasis, but if you have eczema, your skin is more prone to itching. Itching from eczema can be severe.
If you have psoriasis, itching is thought to occur because inflammation in your skin interferes with nerve receptors called nociceptors.
If you have eczema, nociceptors can also be stimulated. However, with eczema, an antibody called immunoglobulin E (IgE) can exacerbate the irritation. This antibody is associated with allergies. Patients with eczema have IgE antibodies, but patients with psoriasis do not.
Affects curved skin surfaces
cause severe itching
May cause scaling or peeling
oozes and scabs
Affects extensor skin surface
Zoom is a major sign
May cause Ospitz sign
Nail Eczema vs Nail Psoriasis
Both eczema and psoriasis are inflammatory skin diseases. This means that inflammation is the cause of the symptoms. However, the cause of inflammation varies with each condition.
Researchers believe that eczema is caused by an overactive immune system. The immune system suddenly malfunctions, causing the body to produce too many white blood cells called T cells. These cells trigger an inflammatory response to protect the body from infection.
In people with eczema, the extra inflammation causes cells in the lymph nodes to pump IgE into the blood. IgE causes the cells in the outer layer of the skin (epidermal cells) to swell.
When this happens, bumps (pimples) and fluid-filled pockets (vesicles) develop on the skin. It also causes tissue to thicken (Lichenization).
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Psoriasis is an autoimmune disease. In this case, the body deliberately causes inflammation because it believes there is a threat.
With psoriasis, the immune system suddenly thinks normal skin cells are harmful. It attacks them by sending T cells.
T cells target new (immature) skin cells called keratinocytes. Inflammation makes cells divide faster. Typically, new batteries take 28 to 30 days to turn around. In psoriasis, they roll over every three to five days.
Cells are being made faster than the body can shed them. Cells push against the surface of the skin and form lesions.
Most health conditions have more than one cause. The same goes for eczema and psoriasis. For example, genetic and environmental triggers appear to play a role in both cases.
Scientists are still trying to understand how genetics are involved in psoriasis and eczema. They know more about things in someone’s environment that might trigger a condition or make symptoms worse.
Because eczema is associated with IgE antibodies, common allergens can trigger flare-ups. These include:
- dust mite
- pet dander
- dairy products
- Nuts and Seeds
- soy products
Both eczema and psoriasis can be triggered by extreme cold and dryness or extreme heat and humidity. Stress can also trigger both conditions.
Things in the environment that can trigger psoriasis aren’t as specific as things that seem to trigger eczema. However, many factors that contribute to the onset of other autoimmune diseases can also trigger psoriasis, including:
- Skin trauma (Koebner reaction)
- Certain medications (such as beta-blockers, lithium, and antimalarial drugs)
Causes of Eczema
overactive immune response
Common Allergen Triggers
Causes of Psoriasis
chronic autoimmune disease
Common autoimmune triggers
Defensive T cell response
Your doctor will examine your skin and discuss your health with you to find out what is causing your symptoms. They may also ask you about any medical conditions in your family.
Your doctor may also take a small piece of skin to look under a microscope (biopsy).
- Eczema: Inflammation causes swelling of the outer layer of skin called the epidermis.When this part of your skin is swollen, it’s called spongiosis. Under the microscope, there will be large spaces between skin cells. There will also be visible pimples and blisters.
- Psoriasis: Inflammation can cause your skin to produce too many skin cells called keratinocytes. When this happens, it’s called hyperproduction. Under the microscope, skin cells look thick and tight (Acanthus).
There are no blood tests or imaging tests that can confirm the diagnosis of eczema and psoriasis.
Diagnosed by observation of the skin (visual inspection)
Causes inflammation of the outer layer of the skin (the epidermis)
looks spongy under the microscope
Diagnosed by observation of the skin (visual inspection)
Causes overproduction of skin cells
The spinous layer looks under the microscope
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The goals of treatment for eczema and psoriasis are the same: to reduce inflammation and improve symptoms. There are some treatments available for both conditions, including:
- Emollient-rich humectants
- topical corticosteroids
- Oral antihistamines (to relieve itching)
- stay away from triggers
Are there home remedies for eczema?
However, the most effective treatment for one condition is not always the most effective treatment for another. Here are some key ways to treat eczema and psoriasis may differ.
- Immunosuppressive drugs: Methotrexate and cyclosporine suppress the entire immune system. They can treat moderate to severe psoriasis. For people with eczema, treatment is only for severe cases.
- Phototherapy: Ultraviolet (UV) phototherapy (phototherapy) is the main treatment for moderate to severe psoriasis. There isn’t a lot of research on using it to treat eczema.
- Topical calcineurin inhibitors: calcineurin Inhibitors are drugs that prevent T cells from being activated in the body. This type of medication is approved by the U.S. Food and Drug Administration (FDA) to treat eczema. They can also be used for psoriasis, but are not officially approved by the FDA. This is called “off-label” treatment. Protopic (tacrolimus) and Elidel (pimecrolimus) are two examples of such drugs.
- TNF Inhibitors: Tumor necrosis factor (TNF) inhibitors block key inflammatory compounds associated with psoriasis. Drugs such as Humira (adalimumab) and Enbrel (etanercept) are examples of TNF inhibitors. This type of medication is not approved to treat eczema and can actually make it worse. The reason is that the inflammatory compounds (interleukins) in eczema are different from those in psoriasis.
less effective phototherapy
Immunosuppressants for severe cases
TNF inhibitor not used
Topical calcineurin inhibitors often used as nonsteroidal therapy
Light therapy is very effective
Immunosuppressants for moderate and severe cases
TNF inhibitor used
Topical calcineurin inhibitors are sometimes used off-label
Eczema and psoriasis are chronic skin diseases. Symptoms may be similar, but causes and treatments are different. If you have skin symptoms such as rash, itching, bumps or lesions, it is important to see your doctor. They may send you to see a dermatologist (dermatologist).
Both eczema and psoriasis can be treated, but in different ways. For example, there are different drugs approved to treat each disease.
Be sure to tell your doctor if you have skin symptoms. Not only can they tell if it’s eczema or psoriasis, but they can also make sure your symptoms aren’t caused by conditions like lupus or skin cancer.
Psoriasis and eczema are common conditions. If you have skin symptoms, you may be wondering if one of these conditions might be the cause. Since they look and feel similar, the only way to be sure is to talk to your doctor.
Once you understand your condition, you can manage it with your doctor. There are many steps you can take that will help if you have eczema and psoriasis, such as avoiding the things that trigger your symptoms.
However, it’s still important to know which disease you have, as some treatments, such as medication, only work with one of them.
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