Difference between psoriasis and eczema: in symptoms and treatment

Many skin conditions are similar, which is why they are often confused. But, having a little understanding of the causes and symptoms, you can separate one disease from another. This also applies to psoriasis with eczema, which have both similar symptoms and pronounced differences. Knowing them, you will definitely not confuse one thing with the other. Let’s say right away that psoriasis and eczema are not the same thing. But for a better understanding, let us consider these diseases in more detail.

What is the difference between psoriasis and eczema

Psoriasis and eczema are different diseases with their own causes, symptoms and treatments. Eczema is a disease in which clusters of bubbles appear on the skin, similar to those that occur when water boils. Hence the name of the disease. Eczeo is translated from Greek as “to boil”. The bubbles break open and form the so-called serous weeping “wells”. They are absent only with the seborrheic form of the disease.

So, the characteristic symptoms of eczema include:

  • erythema – red skin (lesion focus);
  • papules with liquid content;
  • a rash of papules without a clear outline;
  • pronounced itching sensation;
  • erosion, crusts in their place;
  • hair loss in the lesion.

The difference between eczema and psoriasis is quite palpable. First of all, it manifests itself in the external signs observed in the patient. With psoriasis, a psoriatic rash develops that is different from eczema. Typical symptoms of psoriasis:

  • Dry skin and plaque formation that leaves small scales when scraped off. This symptom is called the stearin spot phenomenon.
  • Spots with a red, shiny surface that remain when the scales are removed. This is a terminal film phenomenon and should not be removed as it will bleed.
  • Isolation of exudate with blood when removing the terminal film.

How to tell eczema from psoriasis

The main difference between psoriasis and eczema is external manifestations. With eczema, a blistering rash in the form of small blisters that break open and lead to the formation of crusts. With psoriasis – a psoriatic rash in the form of many spots with scales, when removed, blood begins to flow.

Other differences between eczema and psoriasis:

  • Psoriasis is a disease that has only a chronic form. Eczema is acute (lasts 2 months) and chronic forms. Psoriasis cannot be eradicated permanently, so it is considered a more severe disease. Eczema can be cured with the right treatment.
  • Psoriasis is based on autoimmune processes (inappropriate immune response). The exact mechanism of development of eczema has not yet been clarified. At the same time, the provoking factors of diseases are in many ways similar.
  • Eczema is more common in childhood. Adults encounter it less often. They simply “outgrow” the disease – the symptoms disappear as they grow older. Psoriasis in children and adults occurs with the same frequency, the disease does not depend on age, but develops due to the influence of risk factors.  
  • Eczema affects only the skin, while psoriasis can affect the nails, joints, and internal organs.
  • With eczema, there is severe itching and burning. With psoriasis, itching can be felt only occasionally.
  • Eczema spots do not have clear boundaries, they are blurred. On the other hand, psoriasis spots have contours.
  • Psoriasis can appear anywhere. Eczema affects the most delicate areas: skin folds, inner folds of the limbs, the area between the fingers.
  • With eczema, the lesion has pronounced swelling. With psoriasis, it is practically not observed.
  • Scales with eczema are only in the seborrheic form of the disease. The appearance of bubbles filled with pus is also possible.

It is on the difference in signs that the differential diagnosis of eczema and psoriasis is based. If a patient has a psoriatic triad (the phenomenon of stearin spot, terminal film and “blood dew”), then he is most likely to have psoriasis, since there are no such symptoms with eczema.

How psoriasis and eczema are similar

If we consider what eczema and psoriasis have in common, then it is definitely worth saying that both diseases are not contagious. They are not transmitted from a sick person to a healthy one. This means that it is safe to contact someone with psoriasis or eczema.

Another similarity between psoriasis and eczema is as follows:

  • chronic course with periodic exacerbations;
  • skin lesions in the palms and feet;
  • common provoking factors;
  • heredity (if the parents were sick, that is, the risk of developing the disease in children);
  • several stages of development;
  • the risk of secondary infection.

Features of the treatment of psoriasis and eczema

Treatment of psoriasis is more complex due to the autoimmune nature of the disease. Here, ointment for external use is of particular importance , as well as non-steroidal anti-inflammatory and immunosuppressive (suppress immunity) drugs. In case of joint damage, chondoprotectors are additionally used. 

General principles for the treatment of psoriasis and eczema:  

  • adherence to an individual diet;
  • prevention of stress;
  • rejection of bad habits;
  • psychotherapy and taking sedatives;
  • physiotherapy methods for general health promotion.

Because eczema is very itchy, antihistamines may be used. With the bacterial nature of the disease, antibiotics for external use must be included in treatment.

Can eczema turn into psoriasis?

Eczema and psoriasis can occur at the same time. As a complication or allergic reaction against the background of psoriasis, eczema develops. Instead, there may be another skin disease or a secondary infection when bacteria enter the site of inflammation. But, despite the presence of similar symptoms, eczema cannot turn into psoriasis in any way. These are completely different diseases with a different mechanism of development.

event_note December 14, 2021

account_box Dr. Peter B Milburn

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