Skin problems often result in a lot of discomfort. It’s important to correctly diagnose a skin condition as eczema or psoriasis and treat it accordingly.
Eczema, also called dermatitis, is a group of conditions in which the skin is hot, dry, itchy and scaly. In severe outbreaks the skin may become raw, red and bleeding.
Eczema is thought to be a reaction to environmental irritants or allergies, and symptoms are worsened by stress and hormonal fluctuations.
Psoriasis is a different inflammatory skin condition. It is marked by patches of raised reddish skin, covered with a whitish silver layer. The most common form (plaque psoriasis) is common on the knees, elbows, scalp and the lower back.
- Itchy, inflamed and red skin. The itchiness is a source of severe discomfort and often patients may have difficulty sleeping
- Swelling and cracking of the skin, scaling
- Red crusty rash on cheek
- Blisters or rashes on the arms or legs, near the joints especially behind the knees and inside the elbows
- Hyperpigmented eyelids
- Allergic shiners (dark rings around the eyes)
- Lichenification (leathery skin) from excessive rubbing
- Atopic pleat (Dennie-Morgan fold) - extra fold of skin under eye
- Papules (small raised bumps)
- Ichthyosis (scaly skin areas)
- Keratosis pilaris (small, rough bumps)
- Hyperlinear palms (extra skin creases in the palms)
- Urticaria (hives)
- Lip inflammation (Cheilitis)
- Small red patches that gradually expand and become scaly
- Silvery and red plaques (scales)
- Inflammation and itchiness on the skin
- Cracked skin with blisters
- Restricted joint motion
Types of Eczema include atopic dermatitis or atopic eczema (most common), Allergic contact dermatitis, Irritant contact dermatitis, Dyshydrotic eczema or vesicular eczema, Eczema herpeticum, Adult seborrhoeic eczema, Discoid eczema and varicose eczema.
Types of Psoriasis include Plaque Psoriasis, Guttate Psoriasis, Pustular Psoriasis, Inverse Psoriasis, Erythrodermic Psoriasis, Nail Psoriasis, Psoriasis of the Scalp and Psoriatic Arthritis.
Treatment of Eczema
- Sunbathing or using tanning beds
- Moisturizing body wash, or an emollient like aqueous cream, will maintain natural skin oils and may reduce some of the need to moisturize the skin.
- Bathing using colloidal oatmeal bath treatments.
- Avoiding soap or other products that may dry the skin (such as powders or perfume)
Eczema and skin cleansers
- Avoid harsh detergents or drying soaps
- Choose a soap that has an oil or fat base; a “superfatted” goat milk soap is best
- Use an unscented soap
- Patch test your soap choice, by using it only on a small area until you are sure of its results
- Use a non-soap based cleanser
- Anti-itch drugs, often antihistamine
- Capsaicin applied to the skin acts as a counter irritant
- Topical immunomodulators like pimecrolimus (Elidel and Douglan) and tacrolimus (Protopic)
- When the normal protective barrier of the skin is distrupted (dry and cracked), it allows easy entry for bacteria. Scratching by the patient both introduces infection and spreads it from one area to another. Any skin infection further irritates the skin and a rapid deterioration in the condition may ensue; the appropriate antibiotic should be given.
- UVA is mostly used, but UVB and Narrow Band UVB are also used.
- Cyclosporin, azathioprine and methotrexate.
Diet and nutrition
- Recent studies provide hints that food allergy may trigger atopic. For these people, identifying the allergens could lead to an avoidance diet to help minimize symptoms, although this approach is still in an experimental stage.
- Dietary elements that have been reported to trigger eczema include dairy products and coffee (both caffeinated and decaffeinated), soybean products, eggs, nuts, wheat and maize (sweet corn), though food allergies may vary from person to person.
Treatment of Psoriaisis
- Bath solutions and moisturizers
- Medicated creams and ointments containing coal tar, dithranol (anthralin), corticosteroids, Vitamin
- D3 analogues (for example, calcipotriol), and retinoids are routinely used.
- Narrowband UVB (311 to 312 nm), is that part of the UVB spectrum that is most helpful for psoriasis. Exposure to UVB several times per week, over several weeks can help people attain a remission from psoriasis.
- Ultraviolet light treatment is frequently combined with topical (coal tar, calcipotriol) or systemic treatment (retinoids) as there is a synergy in their combination. The Ingram regime, involves
- UVB and the application of anthralin paste. The Goeckerman regime combines coal tar ointment with UVB.
- Psoralen and ultraviolet A phototherapy (PUVA) combines the oral or topical administration of psoralen with exposure to ultraviolet A (UVA) light.
- Systemic treatment
- Methotrexate, cyclosporine and retinoids.