How To Tell Whether That Itchy Rash Is Eczema Or Psoriasis
A rash is a patch of irritated skin. Almost everyone gets a rash at some point in their lives. Theyre not always a cause for concern, but itchy, red, and painful rashes that dont go away can be a sign of a more serious skin condition.
Eczema and psoriasis are two of the most common skin conditions in the United States. In fact, nearly 32 million Americans have eczema, and another 7.5 million have psoriasis. The causes and treatments of these two conditions are different, but since both cause red, itchy rashes, its not always easy to tell the difference.
Trust your skin care to Oswald Mikell, MD, and our team at Dermatology Associates of the Lowcountry. Were experts in diagnosing and treating eczema and psoriasis, and in this blog were taking a closer look at what makes them different.
Oral Or Injected Drugs
There are a variety of drugs that target skin cell production or your immune system. These include:
Corticosteroids
These medications mimic cortisol, a naturally occurring anti-inflammatory hormone produced by your body. These are normally taken by mouth and can help reduce inflammation. Injected forms can provide temporary inflammation relief.
Long-term use can result in facial swelling and weight gain. It may also increase your risk for osteoporosis.
Disease-modifying antirheumatic drugs
These medications suppress the chemicals in your body that cause inflammation. This can help reduce prevent joint damage. DMARDs are typically taken by mouth but can also be injected.
Biologics
These medications can prevent inflammation on a cellular level. Biologics are typically injected. The main types of biologics are anti-tumor necrosis factor-alpha drugs, abatacept, and ustekinumab. Each blocks different proteins within the body.
Your risk for infection may increase while taking biologics since they work by suppressing your immune system.
How Is Child Arthritis Diagnosed
Childhood arthritis is diagnosed through a physical examination and review of symptoms, X-rays, and lab tests. A doctor should make this diagnosis, particularly a rheumatologist who specializes in arthritis and other related conditions in children. These doctors are called pediatric rheumatologists.
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What Treatment Options Are There
Treatment is aimed at reducing the inflammation of the skin in order to try and reduce the rash.
Unfortunately psoriasis is a chronic skin condition that comes and goes and is not usually curable, but the good news is that it can often be improved.
The treatment your doctor will prescribe depends on the type of psoriasis you have and where the rash is on your body. In brief, the treatment options can be divided into:
- Creams
- Light therapy
- Oral/injected medicines
Symptoms And Treatment For Affected Areas
Psoriasis is an incredibly varied disease. It can present with only a mild rash that isnt easily noticed, or it can present with significant areas of the skin covered in a painful rash. Scalp psoriasis is less noticeable, but can be more difficult to treat with a topical cream. Rashes on the face can have a stigmatizing effect, and the condition almost always involves a rash on other parts of the body as well. As facial skin is more sensitive, different types of treatments may be considered. Be aware that some topical steroids can cause shininess and enlarged capillaries after long-term use on the face.
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Psoriasis White Patches On Skin
Psoriasis is a long-lasting, noncontagious autoimmune disease characterized by raised areas of abnormal skin. These areas are red, or purple on some people with darker skin, dry, itchy, and scaly. Psoriasis varies in severity from small, localized patches to complete body coverage. Injury to the skin can trigger psoriatic skin changes at that spot, which is known as the Koebner phenomenon.
Is Scalp Psoriasis Curable
Dr. Wofford says, Unfortunately, there is no cure for any form of psoriasis, including scalp psoriasis. However, advancing research has enabled your dermatologist to provide effective treatments to prevent flare-ups and manage symptoms when they do arise. That means most people have mild symptoms that do not last long.
There is a range of treatments available for scalp psoriasis. In most cases, youll begin with medicated shampoos, creams, or other topical treatments that you apply directly to the affected areas. Some of these products are available over the counter and in prescription-strength formulas. Prescription topical treatments may also include ingredients like anthralin, antimicrobials, vitamin D , corticosteroids, and/or vitamin A derivatives.
For severe symptoms that dont improve with topical treatment, a combination of in-office and at-home dermatology treatments may be recommended in addition to continuing topical treatments. Some commonly recommended solutions include:
- Laser therapy using low-heat lasers to address itch and redness and improve scalp psoriasis symptoms
- Oral medications corticosteroids, cyclosporine, methotrexate, retinoids , apremilast
- Biologics adalimumab, brodalumab, certolizumab, etanercept, guselkumab, infliximab, ixekizumab, risankizumab, secukinumab, tildrakizumab, ustekinumab
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Signs And Symptoms Of Psoriatic Arthritis
For most people, psoriatic arthritis develops years after psoriasis. Contact your dermatologist if you have psoriasis and any of these signs or symptoms:
- A very noticeable swollen finger or toe
- Swollen and tender joints
- Stiffness when you wake up or sit for hours that fades as you move
- Nails that are pitted
- Nail separating from nail bed
- Lower back pain
Getting A Diagnosis Of Psoriatic Arthritis
The presence of psoriasis may provide an indication of psoriatic arthritis when someone develops joint symptoms. Psoriatic arthritis can develop in people with a lot or a little of psoriasis, and may be more common in people with nail psoriasis. As well as joint symptoms, psoriatic arthritis can lead to feeling tired. Many people become frustrated by a lack of diagnosis psoriatic arthritis tends to have periods of improvement and worsening, which may also be attributed to mechanical joint problems and not inflammatory arthritis.
If you have the symptoms of inflammatory arthritis, such as psoriatic arthritis, your doctor will often refer you to a rheumatologist. In some cases, further tests and imagery may be sought, although this will depend on the individual circumstances and level of confidence in the initial diagnosis.
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What Is Scalp Psoriasis
Scalp psoriasis shows up as itchy, scaly patches on the scalp that may bleed if you try to remove them.
About half of people who have psoriasis have it on their scalp.
At the onset, scalp psoriasis often is confused with seborrheic dermatitis . Dandruff is a flaky, itchy scalp without signs of inflammation .
Scalp psoriasis can spread beyond the hairline and affect the forehead, back of the neck, and areas around the ears.
Often psoriasis in kids is first found on the scalp.
Additional reporting by George Vernadakis
What’s The Difference Between Eczema And Psoriasis
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Children get eczema. They can also get psoriasis.
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While more children develop eczema than psoriasis, almost 1% of children have psoriasis.
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Its not always easy to tell whether a child has eczema or psoriasis. A study conducted in Australia found that most children who had psoriasis were initially diagnosed by their primary care doctor as having another disease, often eczema.
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To a dermatologists trained eye, psoriasis and eczema tend to look quite different.
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What Causes Psoriatic Rashes
Unfortunately, we dont yet know the exact cause of psoriatic arthritis or psoriatic rashes, although certain risk factors may play a role, including genetics and family history.
Roughly 40 percent of people with psoriatic arthritis have at least one close family member with psoriasis or psoriatic arthritis, says Dr. Haberman. Research is still ongoing, however, to determine whether a family history of psoriasis alone can increase your risk of psoriatic arthritis.
Other risk factors for psoriatic rash include:
- Alcohol consumption
- Taking certain drugs
Psoriasis Treatment In San Diego At Cdcri
If you want an expert dermatologist to look at your psoriasis and confirm the diagnosis, come to California Dermatology and Clinical Research Institute in San Diego. CDCRI is headed by Dr. Stacey Smith, an acclaimed and experienced dermatologist, with years working in the field. Not only can we confirm the diagnosis, but we also offer free psoriasis treatment. To learn more, give us a call at 203-3839.
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Clinical Presentation And Differential Diagnosis
1. Hoppe RT, Wood GS, Abel EA. Mycosis fungoides and the Sézary syndrome: pathology, staging, and treatment. Curr Probl Cancer. 1990 14:293371.
2. Dalton JA, Yag-Howard C, Messina JL, Glass LF. Cutaneous T-cell lymphoma. Int J Dermatol. 1997 36:8019.
3. Zackheim HS, McCalmont TH, Deanovic FW, Odom RB. Mycosis fungoides with onset before 20 years of age. J Am Acad Dermatol. 1997 36:55762.
4. Burg G, Dummer R, Nestle FO, Doebbeling U, Haeffner A. Cutaneous lymphomas consist of a spectrum of nosologically different entities including mycosis fungoides and small plaque parapsoriasis. Arch Dermatol. 1996 132:56772.
5. Fitzpatrick TB, ed. Fitzpatricks Dermatology in general medicine. New York: McGraw-Hill, 1993:1285305.
6. Knowles FC, ed. Diseases of the skin. Philadelphia: Lea & Febiger, 1923:316.
7. Hansen ER. Immunoregulatory events in the skin of patients with cutaneous T-cell lymphoma. Arch Dermatol. 1996 132:55461.
8. Demierre MF, Foss FM, Koh HK. Proceedings of the International Consensus Conference on Cutaneous T-cell Lymphoma Treatment Recommendations. J Am Acad Dermatol. 1997 36:4606.
9. Kim YH, Jensen RA, Watanabe G, Varghese A, Hoppe RT. Clinical stage IA mycosis fungoides. A long-term outcome analysis. Arch Dermatol. 1996 132:130913.
Can You Have Psoriatic Arthritis Without A Rash
Although rash is a common indicator of PsA, you can develop PsA without having a rash. About 15 percent of people develop PsA without previously having psoriasis, estimates the National Psoriasis Foundation. Sometimes, people develop PsA and psoriasis at the same time.
In these situations, its important to be aware of what the other symptoms of PsA are.
Although rash is commonly associated with PsA, it isnt the only symptom.
Other symptoms include:
- morning stiffness and low back pain
- swelling, pain, or tenderness in joints
- tendon or ligament pain
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Heat Rash: Sweating That Leads To Bumpy Red Skin
Inverse psoriasis is a type of psoriasis that forms in the armpits and skin folds under breasts or in groin areas, making the skin red and shiny. Sweating makes this type of psoriasis worse. Heat rash also makes your skin red and forms in skin folds of the groin, breasts, and armpits. Heat rash occurs in hot, humid conditions. Sweating can cause your pores to get blocked and result in a bumpy, red skin rash that stings. Heat rash is more common in newborns, but can also affect older children and adults.
Medical Treatment Topical Agents
The first line of treatment for psoriasis includes topical medications applied to your skin. The main topical treatments are corticosteroids , vitamin D-3 derivatives, coal tar, anthralin, and retinoids. These drugs may lose potency over time, so often they are rotated or combined. Ask your doctor before combining medications, as some drugs should not be combined.
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Whats The Outlook Like After Having Guttate Psoriasis
- In nearly two thirds of people the spots clear up and never come back.
- Occasionally the spots turn into a more long-term type of psoriasis called plaque psoriasis. This can be treated with similar creams and light treatment.
- Once its cleared, sometimes a second outbreak of guttate psoriasis happens. This could happen if the streptococcus bug is lurking in your tonsils.
- Thankfully the guttate psoriasis never properly scars, although sometimes it can leave tiny pale marks where it used to be: these should fade with time though.
What Symptoms Should You Look Out For
Unfortunately, its difficult for the average person to tell the difference between eczema and psoriasis. Its best to see a specialist if you spot a rash of any kind that doesnt clear up or returns.
Dr. Ziegner is specially trained to look at various aspects of rashes to distinguish between psoriasis, eczema, and other inflammatory skin conditions. Theres no substitute for expert evaluation. In addition to a visual examination, Dr. Ziegner will go over your medical history and discuss your symptoms.
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What Does Mild Psoriasis Look Like
Dermatologists will also look at the intensity of your symptoms to help determine severity. If your plaques and scales are especially thick, red, scaly, or itchy, that can contribute to your psoriasis being more severe. Psoriasis Location. Having symptoms in places that have a greater impact on your life can also play a role in severity.
What Is Erythrodermic Psoriasis
This is an uncommon but very serious form of psoriasis. Only 3 percent of people with psoriasis will develop erythrodermic psoriasis in their lifetime, according to the NPF.
This type usually occurs in people who have uncontrolled plaque psoriasis.
Erythrodermic psoriasis causes extremely red or otherwise discolored skin that affects most of the body.
Symptoms include:
- Pitting on nails
- Ridges or grooves in your nails
- Lifting of the nail away from the skin
- Crumbling of nails
Many people with plaque psoriasis also have nail psoriasis. For some, however, a single nail involvement may be the only form of psoriasis they develop.
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What Is Guttate Psoriasis
Guttate psoriasis is the second most common psoriasis type.
It affects about 10 percent of people with psoriasis, according to the National Psoriasis Foundation .
Guttate psoriasis, from the Latin for raindrop shaped, causes small, dot-like spots on the body. These lesions frequently appear on the upper arms, trunk, thighs, or scalp.
Often, this form of psoriasis starts in childhood or young adulthood.
Guttate psoriasis can be triggered by a strep infection, tonsillitis, stress, a skin injury, or certain medication . Sometimes genetic factors are to blame.
Guttate psoriasis may clear up on its own, but certain cases require treatment. Some patients may experience guttate psoriasis just once, while others may find it leads to plaque psoriasis.
Treating Eczema And Psoriasis
Dr. Mikell and our team specialize in diagnosing rashes and chronic skin conditions. First, well perform a physical exam to determine the cause of your rashes. Then well recommend a treatment strategy for you. Its possible to have both eczema and psoriasis at the same time.
Neither eczema or psoriasis has a cure, but Dr. Mikell offers several treatment options that can reduce flare-ups and calm your skin. Common treatments for eczema include topical or oral corticosteroids and trigger avoidance. If you have psoriasis, UVB light therapy with XTRAC® may offer relief.
You dont have to live with painful, itchy rashes. Find out whats causing your discomfort and get a treatment plan thats tailored for you. To learn more, book an appointment over the phone with Dermatology Associates of the Lowcountry today.
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What Is Ringworm Symptoms Causes Diagnosis Treatment And Prevention
Ringworm is a very common fungal infection of the skin and nails that has nothing to do with worms. The condition is called ringworm because it tends to cause an itchy, red, circular or ring-shaped rash, according to the Centers for Disease Control and Prevention . It can occur just about anywhere on the body and has different names depending on which part of the body it affects. Types of ringworm include:
Tinea pedis ringworm on the feet
Tinea cruris ringworm on the groin, inner thighs, and buttocks
Tinea barbae Ringworm on the beard area
Tinea manuum Ringworm on the hands
Tinea capitis Ringworm on the scalp
Tinea unguium ringworm on the fingernails and toenails
Tinea corporis Ringworm on other parts of the body, such as the arms or legs
What To Expect At Your Office Visit
Your provider will perform a physical examination and ask about your medical history and symptoms. Questions may include:
- When did the rash begin?
- What parts of your body are affected?
- Does anything make the rash better? Worse?
- Have you used any new soaps, detergents, lotions, or cosmetics recently?
- Have you been in any wooded areas recently?
- Have you noticed a tick or insect bite?
- Have you had any change in your medicines?
- Have you eaten anything unusual?
- Do you have any other symptoms, like itching or scaling?
- What medical problems do you have, such as asthma or allergies?
- Have you recently traveled out of the area where you live?
Tests may include:
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Prevent Chronic Skin Rashes And Inflammation In Chesterfield
The most common symptom of psoriasis for Chesterfield patients is a distinctive skin rash, which can appear as a red, dot-like irritation fiery, crimson-colored lesions in the folds of the skin or scaly patches that itch, crack, and bleed. These rashes most commonly appear on the elbows, knees, and scalp, but they can show up anywhere on the bodyincluding the face.
Psoriasis is a chronic autoimmune disease, which means there is no cure. Its symptoms, however, can be managed and mitigated. Topical or oral medications are typically effective solutions for reducing the severity of flare-ups, but each individuals skin is unique in how it reacts. Sometimes, more work is required to develop a lasting solution.
How Is Guttate Psoriasis Treated
Guttate psoriasis may go away on its own in a few weeks or months. If it doesnt, it can be treated with topical medications, says UFHealth, though applying creams and ointments to the hundreds of tiny drops on your skin can be tedious. Ive done numerous steroid creams over the years, Shurlow says. Dandruff shampoos and moisturizers may help, too, UFHealth says.
is often an effective treatment for guttate psoriasis. Light therapy helped me a lot at first, says Shurlow. But phototherapy can make your skin sensitive to light, UFHealth notes.
If you have a severe case, your doctor might prescribe oral or injectable medications to dampen your inflammatory response. Shurlow has been on a biologic for about 14 years, and it has really helped clear her skin. I feel very fortunate that insurance has covered most of the cost, she says. I still have a copay, but its reasonable. And really, my skin has been much better since Ive been on the biologic.
Antistreptococcal treatment like penicillin or amoxicillin is sometimes used to treat the acute form of guttate psoriasis, especially in children and young adults, but when researchers in Brussels, Belgium, reviewed the literature, they found no evidence of its efficacy or safety. They published their findings in March 2019 in the Cochrane Database of Systematic Reviews.
More trials are needed to assess this guttate psoriasis treatment, they concluded.
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