Many skin rashes are difficult to tell apart. At first glance, psoriasis and eczema share many similarities but they really are very different conditions even though confusingly, they sometimes appear together. Both psoriasis and eczema are chronic skin diseases but one of the main differences is that eczema can be the result of a condition such as asthma while psoriasis may lead to other conditions such as psoriatic arthritis. Additionally, people with psoriasis are at greater risk of developing heart disease, diabetes and depression.
Psoriasis is a chronic genetic skin disease where skin cells mature much faster than normal (in 3 to 4 days instead of 28 to 30) and instead of falling off, the cells layer on top of each other. In plague psoriasis, the most common form of the five types of psoriasis, the skin develops thickened red raised lesions covered with silvery white scales that flake and may even bleed.
Eczema is a term used to describe a generalized skin rash, usually in response to an allergic reaction. The most frequent type is called atopic dermatitis and is frequently triggered by an irritant such as detergent or an allergic response to a food. The rash is red, can be very itchy and may develop blisters and become “weepy”. Eczema can become thickened and look more like psoriasis if the rash becomes chronic.
Both eczema and psoriasis can occur on the scalp, hands, feet, face or neck. However, one clue that separates eczema and psoriasis is that eczema favors the insides of body parts (flexor surfaces) and is more common inside of the arm and backside of the knee while psoriasis favors outside surfaces (extensor surfaces) such as the backs of the elbows or front of the knees. It can be difficult for even a dermatologist to tell the difference between psoriasis and eczema on the hands but with psoriasis, the nails will show pitting even if the cuticle is not involved.
Early treatment for both eczema and psoriasis can be similar. Both use topical lotions, creams, coal tar and steroids. Oral steroids may be used for more severe cases but only for short periods due to potential serious side effects. Light therapy can also be used for both eczema and psoriasis in the form of PUVA (Psoralen + UVA light) which helps deactivate the inflammatory cells but it also has risks of side effects.
Eczema may be treated with oral antibiotics if an area becomes infected and oral anti-histamines such as benedryl can help relieve itching. For more resistant cases of eczema, a newer class of topical prescription drugs called immunomodulators such as Protopic and Elidel. According to about.com, these drugs may give an 80% improvement in an eczema rash.
Psoriasis that is not helped with early therapy may need different systemic medications. One newer class of drugs are called biologics. Biologics are unique because they are able to block specific types of immune cells rather than affect the entire body. However, both immunomodulators for eczema and biologics for psoriasis must be used with care as they can still pose a risk to the body’s immune system.
Eczema may accompany certain illnesses such as asthma or hay fever but psoriasis can lead to other serious conditions. About 10 to 30 % of those with psoriasis develop psoriatic arthritis. Psoriasis is a systemic inflammatory disease that causes increased amounts of cytokins (inflammation-causing proteins) similar to people with cardiovascular disease. People with psoriasis need to be closely monitored by their physicians because of this greater risk of stroke and diabetes.
Both eczema and psoriasis affect large populations of people and can be difficult to keep controlled. Drug research has provided a variety of choices to treat both eczema and psoriasis and hopefully with more advancement, newer drugs will have less risk of side effects.
sources:
www.skincarephysicians.com/eczemanet/atopic_dermatitis.html
www.psoriasis.org
http://psoriasis.about.com/od/symptomsdiagnosis/a/psoriasiseczema.htm
http://news.health.com/2009/06/15/psoriasis-heart-stroke/2/
www.medicalnewstoday.com/articles/101524.php
Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Michele is an R.N. freelance writer with a special interest in woman’s healthcare and quality of care issues. Other articles by Michele can be read at http://www.helium.com/users/487540/show_articles