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What Is Psoriasis and How Does It Differ from Other Skin Conditions (Eczema or Skin Allergy)?

Not all that itches is eczema, and not everything that’s scaly is necessarily psoriasis.  Several conditions can mimic one another and cause red, inflamed and dry appearing patches or plaques on the skin.  Oftentimes, it’s hard to tell them apart!

There are several features and clues that can help differentiate the three most common causes of inflamed skin, which include eczema (also called atopic dermatitis), psoriasis and contact dermatitis.

What Is Psoriasis?

Psoriasis is a chronic autoimmune skin condition caused by an over-reactive immune system leading to persistent skin inflammation.  The skin proliferates too quickly in psoriasis, producing discrete red, thick plaques with silvery white scale. While these psoriatic skin lesions can sometimes be sore or “burnt,” they are typically less itchy than eczema.

Typically, psoriasis appears in adulthood as opposed to eczema which emerges in young children (85% of cases appear by age one). Psoriasis classically favors the outside part of the elbows and knees, but may affect other parts of the arms and legs as well as the face, buttocks, armpits and groin. Involvement of the scalp (mild dandruff or red scaly plaques) and nails (small pits or brown stains, or separation of the nail from the nail bed) is common in psoriasis but not eczema.

Guttate psoriasis is a variant of psoriasis that presents with smaller plaques in an eruptive pattern associated with strep infection.  In psoriatic arthritis, joint pain and stiffness develop. Flare-ups of psoriasis, in general, can be triggered by stress, skin trauma, and certain medications. It is not contagious.

How to Treat Psoriasis: While there is no cure for psoriasis, effective treatments do exist. Steroid and vitamin D creams are usually the first treatments attempted.  In moderate to severe disease, light treatment (phototherapy) and systemic medications (whether by mouth or injectable) are considered.

What Is Eczema?

Eczema, or atopic dermatitis, is a chronic inflammatory skin condition caused by a hypersensitivity reaction.  Eczema usually first appears in childhood, and the majority outgrow the condition by their teens.  There is usually a family history of eczema and a strong association with asthma and hay fever. Like psoriasis, eczema appears red and inflamed. However, eczema is dramatically itchier and less likely to be covered with thick silvery scale. Instead, it can appear dry, cracked, peeling, bumpy, blistered or raw.

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