These two skin conditions are very similar, but knowing the differences helps with treatment
Psoriasis or eczema? These common skin conditions affect a total of about 40 million Americans each year. They result in similar symptoms – red, dry, itchy, cracked skin – but they are very different diseases, with different causes and, in more severe cases, different treatments. That’s why it is important for patients to receive a proper diagnosis, in order to receive the treatment that will best bring relief.
Eczema is by far the more prevalent condition. According to the National Eczema Association:
- 31.6 million people (10.1%) in the U.S. have some form of eczema.
- 18 million adults (7.2%) have atopic dermatitis, the most common form of eczema.
- 9.6 million (13%) children under age 18 have atopic dermatitis.
- Childhood eczema is more common among African-Americans, Asians or Pacific Islanders than whites or Hispanics.
- Adult eczema is most prevalent among multiracial populations than Hispanics or whites.
- Eczema is more common among women.
In contrast, the National Psoriasis Foundation says that:
- More than 8 million Americans have psoriasis.
- Psoriasis often begins between ages 15 and 25, but the condition can develop at any age.
- Psoriasis is more common among Caucasians than African-Americans.
- Psoriasis is more common in women, but men have more severe forms of the disease.
Differences Between Psoriasis and Eczema
Psoriasis is a chronic autoimmune disease. The immune system attacks the skin, causing red, scaly patches on the skin or scalp. There are several types of psoriasis, with plaque psoriasis the most common and making up between 80% and 90% of cases. Other types are called guttate, inverse, pustular and erythrodermic psotiasis.
Eczema, a skin inflammation, can be related to and triggered by allergies, asthma and skin sensitivities to touch, fabrics like wool or chemicals in household and personal products. It can also result from dry skin or chemicals in the environment that irritate the skin.
Neither psoriasis nor eczema is contagious, but both conditions tend to run in families.
Symptoms of Eczema and Psoriasis
Eczema and psoriasis symptoms look very similar, which makes it hard for the average person to tell one from the other. Specialists, though, can differentiate between the two. One clue is the patient's age. “Both can occur at any age, but eczema commonly presents in infancy or childhood, while psoriasis most commonly peaks in the 20 to 30 age group and again in the 50 to 60 age group,” says Dr. Mark Lebwohl, a professor and chair of the department of dermatology at Icahn School of Medicine at Mount Sinai Medical Centre in New York City.
Where the symptoms occur also is telling. “The distribution is different. Psoriasis typically occurs on the back of the elbows and front of the knees, while eczema occurs in the inside folds of joints and the neck,” Lebwohl says. Eczema also generates a liquid that can ooze and crust over, whereas psoriasis rarely oozes, he says.
Treatments for Eczema and Psoriasis
Though each disease has differing underlying causes, they are treated similarly. “We don’t always cure them, but we can help control and manage the diseases,” says Dr. Seemal R. Desai, clinical assistant professor of dermatology at the University of Texas Southwestern Medical Center and a member of the American Academy of Dermatology board of directors.
First-line treatment for mild to moderate cases of both eczema and psoriasis is topical therapy, usually a corticosteroid cream. For more severe cases of psoriasis, there are a host of new medications, both injectable and oral, to treat autoimmune diseases like this. They target the specific immune cells that are behaving dysfunctionally, with Humira being a common, heavily advertised example of this kind of injectable medication. “Patients always think pills are safer than injections, but in this day and age injections are much safer,” Lebwohl says. “They attack just one small part of the immune system, where pills attack a larger portion of that system.”
Another treatment option is phototherapy, “a modified tanning treatment, which is indicated for both eczema and psoriasis,” Dr. Desai says. Ultraviolet light acts as an immunosuppressant on the skin. “Think of high-beam lights on your car. You flash the light to scare off an oncoming car. UV light is similar. There is a specific wavelength of light that scares away immune cells,” he says. Sunlight has the same effect, but it also includes the harmful wavelengths that cause burning. Phototherapy delivers just the one wavelength needed to treat the diseases.
“If you think you have one of these conditions, see a dermatologist early,” Desai recommends. “Even the best general practitioner, this is not their area of expertise. Don’t wait until your skin is so scaly and thick it causes scratching and bleeding.” He has a particular warning for people of color, who he says are underserved and often come in later in the disease process. “See a dermatologist who specializes in treating people of color,” he says.You can find a practitioner and learn more at www.skinofcolorsociety.org.
Self-Treatment for Eczema and Psoriasis
Both doctors recommend patients take good care of their skin, with emollient-rich moisturizing creams and lotions. “Scratching makes small tears in the skin, which can cause infection. An emollient can seal some of those cracks,” Desai says.
For those with psoriasis, losing weight can also be helpful. “The treatments work better if the patient loses weight,” Lebwohl says.
Practicing good general health habits also helps your skin:
- Eat a healthy diet.
- Drink more water.
- Drink alcohol only in moderation.
- Don’t smoke.
- Exercise.
No comments:
Post a Comment