From healthcentral.com
While they may share some of the same symptoms, these two skin conditions are miles apart
You’ve got a round scaly, red patch on your skin. It itches. It flakes. You’ve scoured the internet looking at skin condition photos. It sort of looks like psoriasis? But it also looks like ringworm. So, which is it?
While they’re not caused by the same thing, ringworm (also known as tinea corporis) and psoriasis look and feel so much alike that they can sometimes be mistaken for one another. But knowing what you’re dealing with matters, especially because they’re treated in totally different ways. Find out how you can tell them apart, take care of them, and help prevent them from popping up in the future.
What Are the Differences Between Ringworm and Psoriasis?
There are good reasons why these two skin rashes might be mistaken for each other by the untrained eye. “These conditions both often have circular plaques or patches,” explains Anar Mikailov, M.D., a board-certified dermatologist at Barrington Park Dermatology in Rochester, NY, and co-author of Fitzpatrick’s Color Atlas and Synopsis of Clinical Dermatology, Ninth Edition. But, he says, there are some key differences in their scaly aspect. “With ringworm, the scale is usually at the edge of the circular patch, which is often slightly elevated, and the centre may have normal appearing skin.” With psoriasis, he says the scaling “often covers the entirety of the patch and can become quite hard and attached to the skin with bleeding when the scale is pulled off,” he explains.
Jodi LoGerfo, D.N.P., a doctor of nursing practice and a family nurse practitioner certified in family medicine and dermatology at Orentreich Medical Group in New York City explains that their causes are also different. “Psoriasis is an autoimmune disease that causes skin cells to multiply too quickly,” she says. “This creates patches of red, inflamed, skin with silvery scale. It can affect any area of the body and symptoms come and go over time, called flares.” Ringworm, on the other hand, is caused by a fungal infection on the skin—and despite the name, has nothing to do with worms at all.
Another big difference: Psoriasis is often hereditary and isn’t contagious, while ringworm is not hereditary and is contagious. According to the Centers for Disease Control and Prevention (CDC), it can be transferred to a person through contact with other infected people, animals, or objects.
Symptoms of Psoriasis vs. Ringworm
They both itch, can appear in a circular shape, and have a negative impact on your day—but, other than that, psoriasis and ringworm are very different conditions. Dr. Mikailov points to these main differences:
Location
According to the Cleveland Clinic, ringworm can pop up throughout the body including the hands and nails or under a beard, but may go by different names depending on the area. For example, on the feet it’s called athlete’s foot (but it’s still ringworm). Around the groin upper thighs and rectum, it’s called jock itch (but it’s still ringworm).
Psoriasis can appear in small patches or larges areas anywhere on the body, including the scalp, eyelids, ears, lips, skin folds, hands, feet, and nails, notes the National Psoriasis Foundation. However, unlike ringworm, it tends to cluster in plaques around the joints and become psoriatic arthritis. “This presents as stiffness in the lower back or fingers in the early morning,” says Dr. Mikailov. “It’s very important to treat psoriatic arthritis early, otherwise it can lead to severe joint deformity.”
Raised Areas
With plaque psoriasis, the entire plaque may be raised as the skin cells overproduce and build up. But ringworm is a different story. The term ringworm comes from the way the condition usually presents, as a raised scaly ring around a circular patch with uneven colouring. While a psoriasis flare may also arrive in circular patterns, the entire plaque—not just the outside ring—can be raised as the skin cells multiply rapidly and accumulate.
Symptom Recurrence
Both ringworm and psoriasis can recur. In the case of ringworm, the symptoms may come back if you come in contact with the fungus again. Psoriasis is a chronic condition, meaning that although you can effectively manage symptoms with medication, you likely have the disease for life, and skin flares can repeat if triggered by stress or another internal or external irritant. On the other hand, while a psoriasis flare may temporarily go away on its own, Dr. Mikailov points out that “skin fungal infections require medication pills or creams to clear. [They] typically do not clear spontaneously.”
Causes of Ringworm vs. Causes of Psoriasis
Psoriasis is most often genetic and brought on by contact with triggers including, stress, tobacco, infections, heredity, alcohol, hormonal changes and skin irritants, according to research published in Materia Socio Medica,. However, “there are some types of psoriasis that can develop as a result of a viral or bacterial infection and lead to what is called ‘guttate psoriasis,’” says Dr. Mikailov. “This is often seen after a strep infection or streptococcal pharyngitis.”
Ringworm is caused by fungus, and, according to the American Academy of Dermatology Association, because fungi loves to grow in humidity, people who live in humid climates are more prone to developing ringworm. Other folks who have increased chances of developing ringworm include people who sweat heavily, those who play contact sports, people who share towels, clothes, or razors without washing them, and people who have diabetes (diabetes can weaken the immune system, making it less effective at defending against infections, including fungal ones like ringworm).
How Psoriasis and Ringworm Are Diagnosed
Psoriasis and ringworm are both diagnosed by physical exam and, if necessary, skin biopsy. According to Dr. Mikailov, when it comes to ringworm, “sometimes a bedside test called a ‘KOH Smear‘ can be done where a small amount of skin is scraped off onto a glass slide, and then it is evaluated under a microscope.” If fungus is present, ringworm is the diagnosis. If not, it may be psoriasis or another skin condition.
Psoriasis Treatment vs. Ringworm Treatment
“Skin fungal infection requires an antifungal cream or pill whereas psoriasis requires immunosuppressive therapy such as a topical steroid cream, a pill, or injection therapy,” says Dr. Mikailov. And according to research in the journal Canadian Family Physician, other psoriasis treatment options include phototherapy, vitamin D3, and corticosteroids.
Phototherapy may also be used to treat ringworm—in fact, a 2022 study in Infection and Drug Resistance found that phototherapy combined with oral antifungal medications is a promising therapy for fungal infections. However, the CDC warns against the use of topical corticosteroids as an antifungal, as they can worsen ringworm symptoms.
In both cases, people are advised to wear loose-fitting breathable clothing when skin lesions are present. In the case of psoriasis, wearing looser clothing helps you to avoid friction and irritation. In ringworm, it’s about avoiding the moisture that feeds fungi, according to research in the journal Drugs in Context.
Other Ways to Avoid Ringworm
Even though ringworm is contagious, there are several steps you can take to protect yourself and your loved ones from this pesky condition. Here are the steps to avoiding ringworm, according to the Mayo Clinic:
Educate yourself. Knowing how to spot the signs of ringworm can help you avoid it.
Keep clean. Washing your hands often can help avoid the spread.
Stay cool and dry. Fungus loves humidity, so think breathable clothing!
Avoid infected animals. Steer clear of patches of skin on your pets where fur is missing—this could be a sign of ringworm and should be addressed by a vet.
Don’t share personal items. Keeping your own towels and toiletries can help you from getting in contact with fungus.
Ringworm and psoriasis have enough similarities in appearance that they can be mistaken for each other. But they also have many differences. Psoriasis results from an autoimmune disease that causes rapid skin cell multiplication, while ringworm is caused by fungal skin infections and is contagious, unlike psoriasis. Differentiating their locations, raised areas, symptom recurrence, and causes, you can ensure proper diagnosis and treatment, helping prevent future occurrences.
Skin fungal infections like ringworm necessitate immediate but temporary medication, whereas psoriasis may clear temporarily on its own but may require systemic treatments in the long run. By understanding these distinctions, you can receive the appropriate care for your specific skin condition. When in doubt, however, don’t play a guessing game—head to your dermatologist for an official diagnosis.
https://www.healthcentral.com/condition/psoriasis/psoriasis-vs-ringworm
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