Coexisting skin disorders are a well-known phenomenon. Bacterial infections are often found in patients with eczema or psoriasis, but the presence of several dermatological disorders in the same individual can signal a much-needed visit to your dermatologist.
Eczema and psoriasis are often confused. Psoriasis, an autoimmune skin condition with many faces, is often misdiagnosed as eczema. Another condition, dermatitis herpetiformis, also known as DH and Duhring’s disease, is a skin condition of celiac disease. Extremely itchy bumps or blisters appear on both sides of the body, most often on the forearms near the elbows, as well as on knees and buttocks. DH is not caused by herpes virus; rather, its name is derived because of the appearance similar to the lesions found in herpes infections. DH can also be mistaken for either eczema or psoriasis. There are cases of individuals with eczema and psoriasis or even eczema, psoriasis and dermatitis herpetiformis (DH) simultaneously.
Eczema vs. Psoriasis
There are clinical differences between eczema and psoriasis based on certain well-known characteristics of each. For example, eczema typically presents with dry, red, inflammatory lesions of sandy texture and often prefers moist, hidden areas of the body such as skin folds.
On the other hand, classic psoriasis has thick, scaly, silvery plaques that are found on areas that are exposed to pressure and trauma such as elbows and knees. The challenge is that psoriasis is a condition that manifests in different ways and on different parts of the body.
Plaque psoriasis, characterized by silvery, thick plaques, typically found on muscle surfaces, is easy to recognize. Other types of psoriasis such as pustular psoriasis, which typically affects the palms and the soles of the feet, or inverse psoriasis (dry inflammatory cracks found in skin folds) are often misdiagnosed as eczema.
About 10 to 30% of people with psoriasis will also develop psoriatic arthritis. Symptoms of psoriatic arthritis include stiffness, pain and swelling of the tendons and joints, as well as morning stiffness and generalized fatigue. Many of the treatments for psoriasis and psoriatic arthritis are aimed at controlling the immune response.
Although the cause of a particular psoriasis outbreak may not be known, some common triggers that create flareups include
- Infection, such as strep throat or staphylococcus
- Medications, including lithium, beta blockers and anti-malarial drugs
- Skin injury, including bruises, chafing from tight clothing, shaving, tattoos, vaccinations or sunburn
- Other skin conditions, such as scabies, blisters, boils and dermatitis
- Weather that dries the skin, such as cold winter days and indoor heating or cooling
- Hormones, such as the surges that occur after puberty and during pregnancy
- Smoking and excessive drinking
Dry, irritated skin can be treated with one or more of the following medications:
- Topical corticosteroids
- Topical immunomodulators
- Antibiotics if an additional skin infection is suspected
- Oral antihistamines, which help reduce itching and help prevent scratching at night.
Avoid eczema flareups by adhering to these helpful tips.
- Use lukewarm water (not hot) and use a mild, moisturizing soap. Hot water and soaps tend to dry the skin.
- Apply a moisturizer at least once a day.
- Apply the moisturizer within three minutes after bathing.
- Avoid wool.
Looking to Visit a Dermatologist?
Managing coexisting skin conditions is important and should be overseen by a board-certified dermatologist. Do not try to self-diagnose your skin conditions because there are too many variables to consider. Only a professionally trained dermatologist or physician has the skills to recommend the best treatments. We have multiple locations throughout the country, so fill out our simple online form to get in touch with us. One of our local team members will reach out to you shortly to answer your questions or schedule an appointment for you to visit us soon.
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