Skin problems can cause a lot of discomfort, and some warrant concern beyond just easing the discomfort. It's important that a skin condition be diagnosed correctly, because in spite of a likeness in appearance, every skin affliction calls for different treatments and when unattended to, may lead to different problems. Eczema and psoriasis are two conditions that are often confused for each other, but are very different. Eczema, also known as dermatitis, is a group of conditions in which the skin is hot, dry, itchy and scaly. In severe outbreaks, the skin may become raw, red and bleed. Eczema is thought to be a reaction to environmental irritants or allergies, and symptoms are worsened by stress and hormonal fluctuations. Psoriasis is a different inflammatory skin condition. It is marked by patches of raised reddish skin, covered with a whitish silver layer. The most common form (plaque psoriasis) is common on the knees, elbows, scalp and the lower back.

Comparison chart

Eczema versus Psoriasis comparison chart
EczemaPsoriasis
Cause Eczema is generally a response to environmental factors like exposure to products containing harsh chemicals Psoriasis usually has a genetic link and is the response to factors inside of the body
Age distribution Usually in childhood Generally a disease of adults
Appearance of skin lesion Eczema is described as dry skin that may appear to be small blisters or raised spots. psoriasis is rough, red and raise skin, which can be itchy too.
Silvery scales over the skin lesion Absent Present
Dennie Morgan fold i.e. extra fold of skin beneath the eye Present Absent
Allergy to food May be present Usually not present
Emotional distress Usually not seen May be seen with it.
Arthritis It is not associated with arthritis It is associated with psoriatic arthritis.
Treatment Topical steroids, emollients, antihistamines (loratadine, fexofenadine, cetirazine), tacrolimus, sirolimus, pimecrolimus Topical treatment, cognitive behavior therapy, UV photo therapy, photo chemotherapy, systemic treatment, biological agents (Adalimumab, Efalizumab), topical vitamin A/D derivatives, coal tars, methotrexate
Symptoms pruritus, erythema, xeroderma, ichthyosis Skin plaques, "silver" scales, nail pitting, arthritis
Location face, flexor surfaces extensor surfaces, trunk, lower back, hairline
Causes dry skin, genetic component Immune mediated injury to skin, genetic factors.
Diagnosis clinical Appearance of skin and sometimes a biopsy of skin is carried out.

Causes

Eczema is a combination of genetic and external factors, but the most common occurrence is usually a response to environmental or other external factors, say heat or exposure to products containing harsh chemicals. Only recently, scientists have established that eczema or atopic dermatitis might be caused by a genetic defect in the skin’s epidermal barrier, allowing irritants, microbes and allergens to penetrate the skin and cause adverse reactions.

Eczema can also be triggered by certain types of foods, which makes avoidance of those foods an effective way of controlling the condition in some people.

Psoriasis mostly has a genetic link and is the response to factors inside the body. A problem with the immune system causes psoriasis. Skin cells that grow deep inside the skin rise to the surface in a process called cell turnover. Normally, the process takes about a month, but it happens in just days in a case of psoriasis, because the cells are rising too fast.

In some cases, eczema or psoriasis may be a symptom of an allergic reaction to dietary allergies or food intolerance, especially to milk or wheat (gluten). The allergen could also be another environmental agent such as a type of fabric. If that is the case, identifying the root cause—the allergen—and eliminating it helps alleviate the symptoms.


Age distribution

Eczema is usually considered a childhood condition, much as it can continue well into adulthood for some people.

Psoriasis tends to strike most often in the adult years.

Symptoms

Symptoms of eczema include itchy, inflamed and red skin, swelling and cracking of the skin, scaling, blisters, red crusty rash on cheek, blisters or rashes on the arms or legs, rashes near the joints especially behind the knees and inside the elbows. The itchiness is a source of severe discomfort and often patients may have difficulty sleeping. Other symptoms include hyperpigmented eyelids, allergic shiners (dark rings around the eyes), lichenification (leathery skin) from excessive rubbing, atopic pleat (Dennie-Morgan fold) - extra fold of skin under eye, papules (small raised bumps), ichthyosis (scaly skin areas), keratosis pilaris (small, rough bumps), hyperlinear palms (extra skin creases in the palms), urticaria (hives) and lip inflammation (Cheilitis).

Psoriasis symptoms are mainly small red patches that gradually expand and become scaly, silvery and red plaques (scales), inflammation and itchiness on the skin, cracked skin with blisters and restricted joint motion. About 10% of cases escalate to psoriatic arthritis. Psoriasis also causes a lot of discomfort and emotional distress.

Appearance of the skin lesion

The skin appearance of in case of eczema may resemble that of psoriasis, but they do have evident differences that set them apart from each other. Eczema is described as dry skin that may appear to be small blisters or raised spots. It is also coupled with excessive itching. On the other hand, psoriasis is rough, red and raised skin, which can be itchy too. The main difference between eczema and psoriasis is that the latter is characterized by scaly flaking that may often cause skin bleeding.

Types

Types of Eczema include:

Types of Psoriasis include:

Treatment

Eczema

Psoriasis

References

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