Eczema is a term that describes a group of conditions that cause the skin to become dry, inflamed, irritated, and itchy. There are numerous types of eczema including Atopic Dermatitis, Contact Dermatitis, Dyshidrotic Eczema, Nummular Eczema and Stasis Dermatitis. Eczema is very common and can occur at any time in one’s life from infancy to adulthood. When an irritant or allergen triggers one’s immune system, it causes an increase in inflammation which manifests as eczema on the skin.
Eczema can appear as a pink or red, itchy patch or patches on the skin. Other symptoms of eczema are itching, inflammation, scaling or rough, dry skin. The areas may crust or ooze. These symptoms range from mild to severe depending on the individual. Some people may have only one symptom while others may have all. Symptoms wax and wane throughout life.
While there is no cure for eczema there are numerous effective treatments that control symptoms very well including emollients, topical and systemic medications, and immunomodulators. Sometimes, other underlying issues such as certain medical conditions or allergies can also cause eczema to flare and determining what those are can help to control it.
Psoriasis is a chronic immune-mediated inflammatory skin condition in which an overactive immune system causes the body to make new skin cells in days rather than weeks. The overgrowth of cells does not shed; instead the overgrowth piles up on the skin’s surface and causes thick white scale to appear. These resulting plaques can itch, sting or burn. In addition to the skin, psoriasis can involve the scalp and nails. However, it most commonly involves bony surfaces such as elbows, knees and ankles. Psoriasis is not contagious. It can flare from numerous factors including stress, skin injury, certain medications, streptococcal infections, cold weather and excessive alcohol consumption. Psoriasis cannot be cured; it typically waxes and wanes throughout life.
Psoriasis appears as small or large red papules and plaques with thick white or silvery scale and well-defined borders. When psoriasis involves skin folds there is not scale but instead shiny red plaques. While it can be found anywhere on the body, the most commonly affected sites are the scalp, elbows and knees. When the nails are involved there will be pinpoint pits, yellow-brown discoloration (called “oil spots”) and onycholysis (lifting off of the nail plate). Psoriatic plaques can range from mild to severely itchy and scratching can lead to lichenification (which is a thickening of the skin.) Occasionally, thick plaques can fissure and crack which can be very painful.
Treatment is dictated by the severity of one’s psoriasis, its location on the body and how much of the body surface area is affected. For mild psoriasis, topical therapy is most common and options include emollients, compounds containing tar, salicylic acid, steroids, Vitamin D analogues, calcineuron inhibitors or a combination of some of the aforementioned medications. An effective treatment for moderate to severe psoriasis is phototherapy. Phototherapy is UV radiation often given alone or in combination with a topical or systemic compound. The mechanism of action of phototherapy is not completely understood. However, it is believed that ultraviolet radiation plays a role in immunosuppression and cell cycle interruption in the skin. For severe psoriasis, treatment is often systemic. There are numerous, highly effective systemic medications including certain retinoid compounds, immunosuppressants such as Methotrexate and Cyclosporin and immunotherapy with “biologic” medications which are targeted therapies that can either amplify or suppress an immune response in a person’s body.
*This webpage is for informational purposes and is not intended to be, and should not be relied upon as, medical advice. Any medical concerns should be addressed with a physician.