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Psoriasis or eczema: What’s causing that red, itchy rash?

Psoriasis or eczema: What’s causing that red, itchy rash?

Health
Man with itchy red spots

When it comes to identifying skin conditions, the answers aren’t always obvious. Is the red, itchy rash on your elbow psoriasis? Or is it eczema?
While the two conditions can mimic each another, there are key differences, says Dr. Kimberley Drayton, a board-certified family medicine physician at Tidelands Health Family Medicine at Pawleys Island.
“Psoriasis can be more plaque-like. It’s thicker and has a raised silvery scale formed over the top,” she says. “With eczema, you’ll have more of flat, red patch but it won’t have scales.”
A key differentiator is where the rashes occur on the body.
“Eczema is more frequently seen in the folds of the body — the groin, behind the knee, the inner elbow and the armpit. It can also be in the hairline,” she says. “Psoriasis is common on the outer knee, elbow, lower back or even in the nail beds. Some patients may have divots or pitted nails due to psoriasis.”
Neither condition is contagious.

Psoriasis

Dr. Drayton says different types of psoriasis may cause the skin condition to appear in different places on the body and take on slightly different appearances, but the underlying cause is the same.
Psoriasis is a chronic autoimmune condition that causes an overproduction of skin cells. Instead of sloughing off, the dead cells form silvery-white scaly patches on the skin. The patches are inflamed, red and can itch quite badly.

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There’s no cure for psoriasis, and there’s evidence showing a link with asthma, Dr. Drayton says. Topical steroid creams and prescription medications can keep the condition under control.
“Depending on the severity of the disease and how debilitating it is, patients can lose self confidence along with experiencing physical discomfort. We often prescribe immunosuppressants in severe cases. They have good results and can help reduce flare-ups,” she says.

Eczema

Eczema, also called atopic dermatitis, usually results from an allergic reaction.
“Patients who have asthma, hay fever or food allergies can experience eczema. A dairy or shellfish allergy can increase instances of eczema,” Dr. Drayton says.
With eczema, it’s important to treat the symptoms while managing the allergies that trigger the skin rash. Water-based lotions and topical hydrocortisone creams can help. Consult a physician or other qualified provider for allergy management, but over-the-counter remedies such as Claritin may be beneficial, she says.

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Dr. Drayton says water-based creams and lotions can help reduce symptoms of both eczema and psoriasis.
“Patients with either eczema or psoriasis both have a higher risk of having dry skin. After a shower or bath, pat yourself down and try to leave a little bit of moisture. You don’t want to dry the skin out further,” she says.
If you can’t manage psoriasis or eczema flare-ups on your own, Dr. Drayton says it’s important to consult a physician.
“Skin conditions can be very uncomfortable, so don’t allow yourself to suffer,” she says. “With the right treatment, we can help get eczema and psoriasis under control.”

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