Differences between Eczema and Psoriasis
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Eczema vs. psoriasis[edit]
Eczema and psoriasis are chronic inflammatory skin conditions. While they share symptoms such as redness and inflammation, they differ in their biological causes and clinical presentations. Eczema, specifically atopic dermatitis, is often linked to a hypersensitive immune response to environmental triggers. Psoriasis is an autoimmune condition characterized by the rapid overproduction of skin cells.
Comparison table[edit]
| Feature | Eczema (Atopic dermatitis) | Psoriasis |
|---|---|---|
| Primary sensation | Intense, severe itching | Mild itching, stinging, or burning |
| Appearance | Red, inflamed, or brownish-gray patches; may leak fluid | Well-defined red plaques with thick, silvery scales |
| Texture | Dry, scaly, or crusted skin | Thickened, raised, and "leathery" skin |
| Common locations | Skin folds (elbows, knees), neck, and face | Extensor surfaces (outer elbows, knees), scalp, and lower back |
| Age of onset | Most common in infants and children | Most common in adults between 15 and 35 |
| Biological cause | Skin barrier defect and allergen sensitivity | Autoimmune-driven skin cell overproduction |
| Systemic links | Asthma and hay fever | Psoriatic arthritis and cardiovascular issues |
Pathophysiology and symptoms[edit]
The biological mechanisms behind these conditions differ significantly. Eczema involves a breakdown of the skin barrier, often due to a deficiency in the protein filaggrin. This defect allows moisture to escape and environmental irritants to enter the skin, which triggers an inflammatory response. Itching is the hallmark of eczema. In many cases, the itch precedes the appearance of the rash.
Psoriasis results from a malfunction in the immune system, specifically involving T-cells. These cells mistakenly attack healthy skin cells, which causes the body to produce new skin cells in a few days rather than the standard 28-day cycle. The old cells do not shed quickly enough and instead pile up on the surface of the skin. This accumulation forms the thick, silvery scales known as plaques. Unlike eczema, psoriasis plaques have very sharp, well-defined borders.
Triggers and diagnosis[edit]
Dermatologists typically diagnose these conditions through physical examination. Eczema is frequently triggered by external irritants such as harsh soaps, detergents, dust mites, and animal dander. Weather changes, especially cold and dry air, can also cause flares.
Psoriasis triggers are more often linked to internal stressors or specific physical trauma. Common triggers include emotional stress, streptococcal infections (which can lead to guttate psoriasis), and skin injuries like cuts or burns. Some medications, such as lithium or beta-blockers, are also known to worsen psoriasis symptoms.
Treatment approaches[edit]
Both conditions require long-term management rather than a one-time cure. Topical corticosteroids are used for both to reduce inflammation. For eczema, the primary focus is on restoring the skin barrier through the frequent use of fragrance-free emollients and avoiding known allergens.
Psoriasis treatment often involves more intensive therapies if the condition is moderate to severe. Phototherapy, which uses ultraviolet light to slow cell growth, is a common clinical treatment. Doctors also prescribe systemic medications or biologics. Biologics are injectable drugs that target specific parts of the immune system to stop the inflammatory cycle at its source.
