Health Conditions / Skin Health / Psoriasis

Can You Have Eczema and Psoriasis at the Same Time?

Can You Have Eczema and Psoriasis at the Same Time?

If you have painful skin symptoms that just won’t quit—you know, dryness that leads to obvious cracks, inflammation that just feels awful, or intense itchiness—and you’ve traveled down a rabbit hole via Dr. Google, then you’ve probably come across information on either eczema or psoriasis.These skin conditions are different and complex in unique ways, but their respective lists of symptoms can overlap quite a bit, making them difficult for the average person (read: anyone who’s not a trained dermatologist) to tell apart.If you think that suspicious rash could be a sign of eczema, psoriasis, or maybe even both, here’s some information to help you navigate what you’re experiencing, straight from dermatologists.First, a little bit about how psoriasis is defined.At its core, psoriasis is an autoimmune condition, meaning it’s caused by a glitch in the immune system that causes the body to mistakenly attack healthy skin cells. Because of this immune malfunction, the body overproduces skin cells, which then accumulate and pile up on the skin’s surface, according to the American Academy of Dermatology (AAD).Plaque psoriasis, the most common form of the condition, causes raised lesions—often with a scaly appearance with a silver-to-gray plaque, depending on your skin tone—that can manifest anywhere on the body and feel itchy, tender, or even painful.There are various forms of psoriasis, so the symptoms can vary widely. But plaque psoriasis often appears on areas like the elbows, knees, trunk, and scalp, Esther Kim, MD, an assistant professor of dermatology at Columbia University Medical Center, tells SELF. You may even start to feel pain in your joints: When inflammatory arthritis occurs alongside psoriasis, it’s called psoriatic arthritis, Dr. Kim says.Many people with psoriasis experience flare-ups, or periods of time when symptoms become more active. These flares can last anywhere from weeks to months, and there is a range of triggers that can set them off, from infections and illnesses to skin stressors (like cuts and scratches) to changes in weather and stress levels, per the AAD.Like other autoimmune conditions, the root causes of psoriasis aren’t well understood, but researchers believe that both environmental and genetic factors are at play, Dr. Kim says.…and here’s a little eczema 101.Eczema is an umbrella term for a group of skin conditions in which the skin barrier (the outermost protective layer) is damaged, leading to itchy, dry, and inflamed skin, per the AAD. Eczema is broadly referred to as atopic dermatitis, the most common form of the condition, but there are various types of eczema that have different triggers. An eczema rash can look and feel different from person to person but may include small raised bumps, dry or cracked skin, itchiness, and oozing or crusting, among other symptoms that generally signal irritation. “Intense itch is a hallmark of eczema,” Dr. Kim notes. “Because of the itch, patients often suffer from a persistent itch-scratch cycle that can lead to thickening of skin and scratches that render the skin prone to superficial skin infections.”

Here’s How Psoriasis Can Affect Your Entire Body

Here’s How Psoriasis Can Affect Your Entire Body

Psoriasis is a chronic skin condition at its core—but there’s a lot more happening beneath the surface. Psoriasis—which affects an estimated 7.5 million people in the US—is the result of an overactive immune system, which causes chronic inflammation. While we most often see the effects of this inflammation in the skin, it can also travel to other areas of the body, potentially affecting the nails, eyes, joints, heart, and more.Read on to understand exactly what happens when you have psoriasis, how it might affect your body beyond the skin, and some treatment options that can help.What’s happening with your immune system?When your body needs to respond to an infection, an injury, or a substance that threatens your health in some way (like an allergen), your immune system should kick in to release various cells that fight potentially harmful invaders and protect the body. These cells travel to the affected area and start the healing process, causing inflammation. Here’s the problem: When your immune system is in overdrive, as is the case with any autoimmune condition, including psoriasis, it continues to pump out a large number of inflammatory cells, even when there’s no true threat to the body happening.In people with psoriasis, it’s thought that there’s a faulty immune response that mistakenly identifies healthy skin cells as threatening, which causes the repair system to malfunction. This kicks off an overgrowth of new skin cells, which is what causes the hallmark psoriasis rash. The majority of people with psoriasis have plaque psoriasis, in which the “rash” appears as scaly patches, or plaques, on the skin’s surface.This rash is just one visible sign of inflammation, but a doctor can measure inflammatory markers in your blood, Benjamin Ungar, MD, an assistant professor in the department of dermatology of Icahn School of Medicine at Mount Sinai, tells SELF. People who have psoriasis are more likely to have other autoimmune conditions as well, including certain forms of arthritis and inflammatory bowel disease (IBD). In fact, 25% of people with autoimmune diseases have more than one type—often a skin condition among them, research shows.1And constantly having higher-than-normal levels of inflammation can wreak havoc on everything from your joints to your arteries, potentially leading to confusing body-wide symptoms.Psoriasis and your cardiovascular healthHaving moderate-to-severe psoriasis ups your risk for cardiovascular health issues and metabolic diseases, like high cholesterol and obesity, Dr. Ungar says. While there’s not a clear-cut reason why psoriasis may play a role, research suggests that systemic inflammation in the body is associated with a buildup of plaque and cholesterol in your arteries, which can eventually block healthy blood flow and put you at risk for heart disease.2Because of these potential health risks, it’s a good idea for people with psoriasis to have annual blood pressure and cholesterol readings, and talk with their physician about any family history of heart disease, Samar Gupta, MD rheumatologist and associate professor of medicine at the University of Michigan Medical School, tells SELF. Beyond these checkups, focus on what’s in your control, such as working closely with your care team to find the best treatment for your psoriasis and adopting heart-healthy habits like eating a nutritious diet and exercising regularly in some way, he adds. Getting proper sleep and prioritizing stress-reducing habits are key too.Psoriasis and your jointsAbout 30% of people with psoriasis develop psoriatic arthritis, an inflammatory condition of the joints, tendons, and ligaments, according to the National Psoriasis Foundation. Most people are diagnosed with psoriasis first, though it is possible to develop the symptoms of psoriatic arthritis—such as joint pain, lower back pain, and swelling in fingers, toes, and feet—before psoriasis, says Dr. Gupta.

Here’s What People of Color Need to Know About Psoriasis

Here’s What People of Color Need to Know About Psoriasis

Not recognizing this shade difference may be why some doctors confuse psoriasis with everyday skin irritation, eczema, a drug reaction, or even an infection in people of color, says Dr. Robinson. But there are other clues that may point to psoriasis.For example, “you can touch the patient and feel that the inflamed area is usually warm,” says Dr. McKinley-Grant. A thorough dermatologist will ask about your family history since the condition can (but not always) have genetic roots, she adds. In case your doc is uncertain, they might also take a small biopsy (a skin sample) and examine it to be sure of the diagnosis and rule out any other skin conditions.2. Rare types of psoriasis tend to be more common in people of color.While plaque psoriasis is the most prevalent form of the condition, “there are also rare subtypes that appear more frequently in certain racial and ethnic groups,” Dr. Robinson says. For example, researchers have found that pustular psoriasis—which appears as inflamed, scaly, pus-filled bumps4—is more common among Asian and Hispanic communities.5Asian people are also more likely to have erythrodermic psoriasis,5 which covers the body in a red, burn-like rash and can be fatal if it’s not treated quickly. What’s more, Asian and Black people tend to be more vulnerable to scalp psoriasis, in which plaques pop up around the scalp, hairline, forehead, back of the neck, and on the skin around the ears.6This is important to know because getting an accurate diagnosis can be complicated if you’re dealing with a form of psoriasis that’s rarer in white people, according to Dr. Robinson, especially if you’re seeing a doctor who’s not experienced in treating darker skin. (You can check out our resources below to help you find a doctor who is well-versed in treating darker skin tones.)3. Certain treatments may not be ideal for your skin color and hair type.While there is still no cure for psoriasis, there are plenty of treatment options to help keep the symptoms at bay, no matter how much melanin is in your skin. These include prescription-strength creams and ointments, phototherapy, oral and injectable medications, and scalp oils and shampoos, among others.However, special considerations need to be made for a few treatments. One, for example, is phototherapy, which involves exposing the skin to a controlled amount of ultraviolet light. “People with darker skin tones require higher doses of phototherapy in order for it to be effective,” Dr. Takeshita says. However, phototherapy can tan the skin and make any unwanted dark spots you have darker, which people of color are especially susceptible to, according to the AAD. If that’s the case for you, standing in a lightbox a couple of times a week may not be the best way to go.For scalp psoriasis, you also need to think about your natural hair texture, how often you prefer to wash it, and how you like to style it, says Dr. Robinson. Frequent shampooing with medicated formulas, which may be recommended in combination with oral medication, can help to remove the scales, but if you have dry hair or washing often doesn’t align with your hair care routine, there are other options out there to help keep your hair as happy as possible.

Here’s How to Tell Psoriasis Apart From Other Skin Conditions

Here’s How to Tell Psoriasis Apart From Other Skin Conditions

Eczema can cause pink to brownish-gray patches of inflamed skin, depending on your skin tone, especially on your hands, feet, ankles, wrists, neck, upper chest, eyelids, and around the elbows and knees. One thing to keep in mind: “Eczema is more commonly found on the inside of the knees and elbows,” Dr. Wassef says. “Psoriasis is more common on the outside of the elbows and knees.”Those rashes are a little different from what you’d see compared to, say, plaque psoriasis, board-certified dermatologist Ife J. Rodney, MD, founding director of Eternal Dermatology + Aesthetics and professor of dermatology at Howard University and George Washington University, tells SELF. Psoriasis tends to be more raised and can have that silver or grayish scale on top of the irritation. While both eczema and psoriasis can cause itching, the latter can also be painful, Dr. Rodney says. A stinging or burning sensation is also common with psoriasis.The main triggers also tend to be different. Eczema triggers, per the AAD, tend to be irritants or allergens that touch the skin and set off a reaction, like certain foods or ingredients in skin-care products and soaps. In this case, it’s common for the rash to just show up in the one affected spot, Dr. Rodney points out. Psoriasis triggers aren’t as cut-and-dry; flares are typically related to stress, weather changes, illnesses and infections, skin injuries, and certain medications, according to the AAD, but contact with irritating substances may worsen affected areas as well.Psoriasis vs. hivesHives are raised, itchy bumps that can form on your skin in response to a trigger, like an allergen or an infection, according to the American College of Allergy, Asthma, and Immunology (ACAAI). While you probably won’t confuse plaque psoriasis with hives, the differences are a little less clear when it comes to guttate psoriasis, since this type of psoriasis shows up as tear-drop-shaped, inflamed lesions that can look similar to hives.However, there are a few differences in the look and feel between guttate psoriasis and hives. “Hives usually start and end within 24 hours, while psoriasis can last for weeks and months,” Dr. Wassef says. Hives are also “very itchy” and can get more swollen when you scratch, she adds, which isn’t usually the case with guttate psoriasis.Guttate psoriasis also usually follows an upper respiratory infection like strep throat, according to Mount Sinai experts, and the bumps tend to be scaly. Hives, on the other hand, tend to resemble swollen bug bites, per the ACAAI.Nail psoriasis vs. fungal infectionIf one or more of your nails start to become discolored, lift up from the nail bed, or even appear crumbly, it’s easy to think you might have some kind of fungal infection. But all of those can be signs of nail psoriasis as well, which the AAD says about half of people with plaque psoriasis will experience at some point. Both conditions can appear quite similar, but there are a few differences. With nail psoriasis, “the nail can develop pitting, stripes, and become so brittle that they crumble,” Dr. Rodney says, but there often isn’t as noticeable discoloration. With a fungal nail infection, the entire nail will often turn yellow or brownish. Fungal infections can also be stinky, per Dr. Rodney.

People With Psoriasis Share the Most Helpful Questions They’ve Asked Their Doctors

People With Psoriasis Share the Most Helpful Questions They’ve Asked Their Doctors

A psoriasis diagnosis can be overwhelming. Suddenly, you’re told you have a chronic skin condition with no cure—and that’s a lot to take in. So, it’s totally understandable if go through the rest of your doctor’s appointment in a daze. Once you come out of it and process this information, you probably have questions. Like, a lot of questions.While your doctor will probably run through the basics—symptom management, recognizing flares, treatment options—they can’t cover everything in one appointment or even know all of the details you need for your particular lifestyle. That’s why connecting with other people who have psoriasis—about 7.5 million in the U.S., according to the American Academy of Dermatology (AAD)—can be helpful.With that in mind, we spoke to several people living with psoriasis to learn the best questions they’ve asked their doctors—and why their answers were so helpful. Keep these on the back burner for your next doctor’s visit if you’re still navigating the nuances of this disease.1. Can psoriasis affect my health beyond my skin?Fitness and nutrition coach Lauren Scholl was diagnosed with psoriasis when she was 16 years old, and she didn’t fully understand at the time how the condition could impact her overall health.“Everyone suffers from psoriasis differently,” she tells SELF. “I had it on my elbows and ankles and I was like, ‘Nobody notices those things. I’ll live with it.’” But Scholl, now 34, says it wasn’t until she started asking questions that she learned psoriasis could be linked with other symptoms she was experiencing, like joint pain.When she was 28, Scholl was diagnosed with psoriatic arthritis, a chronic inflammatory arthritis that affects roughly 30% of people who have psoriasis.1 “I definitely never would have thought that my skin patches could be linked to joint pain,” she says. “Nobody ever asked me if I had joint pain. If they had, I would have said ‘yes’ and I could have been properly treated sooner than I was.”2. What do I need to know about my type of psoriasis?Sarah Boutwell was diagnosed with psoriasis when she was 12 and psoriatic arthritis when she was 23. Now, at 37, Boutwell tells SELF she’s struggled with symptoms like red, itchy patches on her elbows and knees and smaller red dots on her legs and arms.“I have red spots on 85% of my body most of the time,” Boutwell says. “But now that I’m at an age where I don’t care what people think anymore, I’m no longer afraid to wear shorts and other clothes that show my skin. My skin deserves to see the sun without being judged for my spots.”Boutwell says it’s been helpful for her to find out more about her particular form of psoriasis: guttate psoriasis. (Psoriasis can appear in many forms, including plaque psoriasis, which is the most common type, as well as guttate psoriasis, inverse psoriasis, pustular psoriasis, and erythrodermic psoriasis, all of which have unique symptoms that affect the skin differently.)

Psoriasis Vs. Eczema: How to Tell Them Apart

Psoriasis Vs. Eczema: How to Tell Them Apart

If you’ve got itchy, discolored, and flaking patches of skin, it’s natural to be a bit concerned about what’s causing those symptoms. And while it’s always best to book an appointment with a dermatologist when new skin symptoms crop up, it’s inevitable that you’ll be doing a little bit of self-diagnosis (hello, internet research rabbit hole), and likely doing a psoriasis vs. eczema comparison.Psoriasis and eczema are two fairly common skin conditions, and both cause symptoms of itching and visible inflammation. These two conditions also share a few other similarities: They’re both chronic, which means symptoms are managed, not cured, and both can be triggered by genetics and environmental factors.That being said, the treatment options and long-term management of psoriasis and eczema are quite different. So, it’s important to know for sure which one you are dealing with. “Both eczema and psoriasis cause inflamed, scaly areas on the skin, and to the untrained eye, they can look similar,” Alan J. Parks, MD, a board-certified dermatologist in Columbus, Ohio, tells SELF.SELF spoke with several board-certified dermatologists to lay out the difference between eczema and psoriasis.What are psoriasis and eczema, exactly?Psoriasis is an autoimmune condition that affects about 7.5 million Americans, according to the American Academy of Dermatology. It happens when your skin cells go through their life cycle more quickly than normal. Typically, it takes about a month for skin cells to regenerate, but in people with psoriasis, this cell-turnover process happens every three to four days, according to the Cleveland Clinic. The buildup of new skin cells results in flaky scales on the skin’s surface.Eczema is much more common than psoriasis, affecting between 2 and 10% of all adults.1 Eczema causes patches of dry, itchy skin that tend to turn into a rash when you scratch or rub it. These patches are prone to bacterial, viral, and fungal infections. That’s because, at its core, eczema is tied to a gene variation that affects the skin barrier and its ability to protect your skin from everything from bacteria to irritants and allergens. Eczema flares are triggered by environmental and lifestyle factors, such as irritating skin care products, dry skin, and stress. The main symptom of eczema is itchy, flaky skin, but people who have eczema as children are more likely to develop asthma and environmental allergies.Back to topWhy are eczema and psoriasis sometimes mistaken for each other?Eczema may sometimes be mistaken for psoriasis because it causes a painful, itchy rash that may even appear raised. To the untrained eye (or anxious self-diagnoser), this might make an eczema patch look like a psoriasis plaque.Psoriasis and eczema aren’t likely to be confused by a trained dermatologist, though, Azeen Sadeghian, MD, FAAD a board-certified dermatologist in Baton Rouge, Louisiana, tells SELF. But she notes that there are some exceptions. “Some cases are challenging because the eczema patches have become thickened enough to resemble psoriasis,” she says. Experts call this thickening “lichenification.”It’s tempting to think of eczema as “psoriasis light,” which will eventually worsen and become psoriasis. But eczema will not develop into psoriasis. They are two separate conditions, with separate underlying causes. However, it is possible to have both eczema and psoriasis. This condition is called eczematous psoriasis, sometimes known as PsE, according to a 2015 study published in the Journal of Clinical Medicine.2Both psoriasis and eczema cause redness on lighter skin tones. If you have darker skin, that redness might look more like brown or purple discoloration. These differences can sometimes lead to a misdiagnosis, or a delay in the time it takes to get a proper diagnosis, according to the National Eczema Foundation. “It might be harder to perceive redness or what we call erythema because of the pigment of the skin,” explains Dr. Sadeghian. She also points out that psoriasis can rev up the pigment production in skin of color, causing darker plaques.The National Psoriasis Foundation notes that a delay in diagnosis can mean people with darker skin tones aren’t able to take advantage of early treatment options. Research is still underway to understand how to best identify psoriasis in people with darker skin tones.Back to topWhat is the age of onset for psoriasis vs. eczema?One big difference between eczema and psoriasis is the age of diagnosis. Eczema is commonly found in children, many of whom grow out of their symptoms or see a severe reduction in symptoms as they age. That doesn’t really happen with psoriasis.

Psoriatic Arthritis Symptoms Can Affect More Than Your Joints

Psoriatic Arthritis Symptoms Can Affect More Than Your Joints

According to the Cleveland Clinic, it’s also possible to have overlapping types of psoriatic arthritis, potentially making this disease even more complicated.Back to topWhat does psoriatic arthritis pain feel like?“Often, people with psoriatic arthritis describe generalized feelings of achiness and fatigue before any overt swelling starts,” Rebecca Haberman, MD, a rheumatologist and assistant professor of medicine at NYU Langone Health, tells SELF.The next clue is joint pain or stiffness, swelling, and warmth. Nail changes, lower back pains, swollen fingers or toes, eye inflammation, and foot pain often follow after that.When it comes to the question of how painful psoriatic arthritis is, the answer is that it can vary. For some people it can be mild, and for others, severe. With psoriatic arthritis treatment, you may still experience flares-ups that alternate with periods of remission, according to the Mayo Clinic. As the disease advances, Dr. Haberman says they can see joint damage, which is often irreversible once it develops.Back to topWhere does psoriatic arthritis usually start?“In about 85% of people with psoriatic arthritis, skin psoriasis appears before any joint involvement,” says Dr. Haberman. However, she adds, when it comes to joints, there is no one joint or area where psoriatic arthritis typically starts. “This is different for every person, and a single joint or multiple joints may be involved even at the start,” she says.In addition to having possible joint swelling and pain, Dr. Haberman says people often describe feeling stiff, fatigued, or having more difficulty doing activities that they used to do on a daily basis. “Psoriatic arthritis can also present as back pain and stiffness if it affects the spine or areas of inflammation at the entheses, where ligaments and tendons insert onto the bone, such as the Achilles,” says Dr. Haberman.Back to topWhat organs does psoriatic arthritis affect?Yes, psoriatic arthritis can wreak havoc on your joints and skin, but it can also cause problems in other parts of your body. That’s because psoriatic arthritis causes systemic inflammation—from your eyes to your heart, says Dr. Askanase. It can involve the eyes with uveitis, the gut with inflammatory bowel disease, your heart with early cardiovascular disease, lung inflammation, and liver and kidney problems. “In other words, psoriatic arthritis can be a disease of the whole body,” she says.That said, while psoriatic can increase your risk for these other conditions, it doesn’t mean that you will get them. It’s a good idea to talk with your healthcare team about how to reduce any risk factors you might have, including getting your PsA under control and tweaking your treatment plan, if necessary. These things will help reduce your risk of complications.Back to topDoes psoriatic arthritis show up in blood work?While blood tests are an important factor in supporting a diagnosis of psoriatic arthritis, Dr. Haberman says they cannot alone diagnose psoriatic arthritis. “Psoriatic arthritis is diagnosed by history and physical exam, and often supported by imaging and blood work,” she says.People with psoriatic arthritis may have elevated levels of inflammation in their blood (such as elevated c-reactive protein or erythrocyte sedimentation rate). However, she says these are non-specific markers of inflammation, meaning that any cause of inflammation—not just psoriatic arthritis—can make them elevated.The only way to know for sure if you’re dealing with psoriatic arthritis is to talk with your doctor. They will go through the necessary steps to get a proper diagnosis. If you are diagnosed with psoriatic arthritis, starting on a treatment plan will help manage your symptoms and prevent joint damage, and hopefully get you back to feeling a bit more like yourself.

4 People on How Their Lives Changed After Finding the Right Psoriasis Treatment

4 People on How Their Lives Changed After Finding the Right Psoriasis Treatment

Although Skiles still has a few psoriasis patches on her elbows, knee, and scalp, her confidence has improved to the point where she now wears sleeveless shirts and skirts that show her skin—something she never did before. “Psoriasis used to impact what I wore because I wanted to cover my skin,” Skiles says.3. “I participate in my life again.”Kendra Gerein, 27, was diagnosed with psoriasis when she was just a year old. She says her skin was always dry, itchy, inflamed, scaly, and painful, which affected her life in every way.Gerein had a bad experience with treatment as a child—the details are fuzzy but it ended with her becoming so itchy that she was hospitalized at age 6. After that experience, Gerein didn’t take any prescribed medications for her psoriasis, and her pain got worse.“I would not go to events or join in on fun activities due to discomfort, insecurities, and irritability,” Gerein tells SELF. “I remember my parents took me to the Grand Canyon and I barely got out of the vehicle because the wind hurt my skin, my knees were cracked so I couldn’t walk, and I constantly scratched,” she says.Now, Gerein has figured out a skin-care routine, with the help of her dermatologist, that has greatly reduced her psoriasis flare-ups. She takes Epsom salt baths, uses moisturizing, fragrance-free lotions and soaps, and manages her stress as much as possible. Stress can trigger psoriasis, and Gerein notices a correlation between her stress level and frequency of flare-ups. Gerein only has a few plaques during flare-ups, which has transformed her life. “I have more energy, I am happier, and I participate in my life again,” she says. “I love the outdoors now,” she says. One of her new favorite activities is swimming in the ocean. “The water used to sting so badly that I didn’t experience many ocean swims or activities when we were on vacation,” she says.4. “The psoriasis seems more predictable than it was in the past.”Samantha Holmgren, 31, was diagnosed with psoriasis when she was just two years old. “It went away for a while when I was a kid but came back around age 10 or so,” she tells SELF.At one point, psoriasis plaques covered Holmgren’s neck, back, and calf and dotted her lower back and thighs. In her teens and early 20s, Holmgren only wore clothes that hid her psoriasis, which kept popping up all over her body. “I was never quite comfortable in my skin,” she says. Several years ago, Holmgren started using a high-strength prescription steroid cream, which reduced her psoriasis plaques so only her ears and scalp were affected. When she became pregnant in 2020, Holmgren switched to an over-the-counter steroid cream that comes with fewer side effects—and she still uses it. “I just have to remember to use the cream every day to get the psoriasis back under control,” she says. “I’m getting fewer new patches showing up. The psoriasis seems more predictable than it was in the past,” she says. Even more importantly, Holmgram says she feels more comfortable and confident in her skin. In fact, she wore a sleeveless dress at her wedding in 2017 despite having plaques on her shoulder. “That was the moment I realized how far I’d come in feeling comfortable and confident.”

Is It Pustular Psoriasis or a Skin Infection?

Is It Pustular Psoriasis or a Skin Infection?

You’ve probably heard of psoriasis—the chronic inflammatory condition that can cause itchy, scaly patches on your skin. Less well-known is a rare form of the disease called pustular psoriasis, which affects roughly 1% of people with psoriasis.1Pustular psoriasis is characterized by pustules, or small pus-filled bumps that can be incredibly painful.2 Not surprisingly, they can severely affect your quality of life, especially if the pustules are located on areas that need to withstand pressure, like the soles of your feet, or on highly visible skin, like your face. This condition might be uncommon, but it’s important to distinguish pustular psoriasis symptoms from an infection because it can be easy to mistake the two. Here’s everything you need to know about pustular psoriasis, including the symptoms, causes, and treatment.What is pustular psoriasis? | What causes pustular psoriasis? | Pustular psoriasis types | Pustular psoriasis treatments | What makes pustular psoriasis worse? What is pustular psoriasis?Pustular psoriasis is a rare type of psoriasis that, similarly, goes through periods of flare-ups and remissions. During a flare-up of pustular psoriasis, the inflamed skin will be covered with small bumps filled with pus, or pustules. These bumps may spread, join together, and break open, according to the American Academy of Dermatology (AAD).It’s important to note that pustular psoriasis isn’t just a skin condition. “It’s a multisystem inflammatory disorder,” Dawn Davis, MD, a pediatric and adult dermatologist at Mayo Clinic, tells SELF.3 “A lot of people assume that when you get psoriasis it’s limited to the skin only, but we’re understanding more and more that it really is a disease that is multi-organ and manifests more obviously in the skin.”This means that the chronic inflammation associated with pustular psoriasis can affect other areas of your body as well. What’s more, there’s increasing research indicating that all forms of psoriasis are associated with a variety of diseases that involve chronic inflammation such as inflammatory bowel disease, arthritis, and even cardiovascular diseases.4 However, there’s no evidence that pustular psoriasis causes other inflammatory diseases—researchers are still trying to understand the connection.Back to topWhat causes pustular psoriasis?Experts don’t know the exact cause, but they do know pustular psoriasis is the result of an overactive immune system that attacks healthy cells in your body, according to the Centers for Disease Control and Prevention (CDC). The fluid that fills the pustules consists of white blood cells, which are immune cells that the body normally sends to fight infection.5Although the causes of pustular psoriasis remain a mystery, experts have honed in on a few risk factors for the condition. Research shows that pustular psoriasis is associated with genetic mutations of the CARD14 gene, which helps regulate genes responsible for the immune system, according to the NLM. People with these mutations may be susceptible to developing the condition, which can be triggered by a particular event, such as an infection, smoking, or pregnancy.6Quitting certain medications—oral corticosteroids, in particular—is another common trigger of pustular psoriasis, Lawrence Green, MD, a board-certified dermatologist and clinical professor of dermatology at George Washington School of Medicine and member of the American Academy of Dermatologists board of directors, tells SELF. Oral corticosteroids are commonly prescribed to treat plaque psoriasis, and your immune system can have an adverse reaction when you finish a course of medication.7 This is why people commonly have both plaque psoriasis and pustular psoriasis.Getting diagnosed with pustular psoriasis can be tricky. It can be hard to tell at first glance (even for your doctor) whether the pus is a sign of infection or psoriasis. The only way to confirm is to take a culture of the pus to find out whether there are bacteria inside. If it is pustular psoriasis, then the bacterial culture will be negative, because pustular psoriasis is not caused by an infection and, therefore, it’s not contagious. Another option is for your doctor to take a biopsy of your skin to be examined under the microscope.Back to topWhat are the different types of pustular psoriasis and their symptoms?All pustular psoriasis is characterized by fluid-filled pustules. To start, you may develop tender, reddened skin followed by pustules that generally pop up a few hours after your initial symptoms, according to the Mayo Clinic. “A lot of people suspect these bumps are an infection when actually they’re not,” Dr. Davis says.Oftentimes, the pustules merge and then burst open,8 resulting in a scaly, cracked, and painful rash. More pustules can form, and the cycle repeats, according to the AAD.  Flares may last up to months without pustular psoriasis treatment.The different types of pustular psoriasis are defined by the area of the body where the pustules appear.Palmoplantar pustular psoriasisAs the name suggests, palmoplantar pustular psoriasis commonly affects the palms of the hands as well as the soles of the feet. The pustules often develop in sweat ducts,6 which are more densely packed on the palms and soles than anywhere else on the body. As with other types of pustular psoriasis, the skin typically becomes irritated and inflamed before breaking out in pustules. A scaly plaque usually forms several days after the pustules form, according to the National Organization for Rare Disorders (NORD). You may have a burning sensation in your hands and feet that make it hard to stand or touch anything.

10 Questions to Ask Your Doctor Before Taking Biologics for Psoriasis

10 Questions to Ask Your Doctor Before Taking Biologics for Psoriasis

If all of those check out and you still have a choice to make, consider this: Are you comfortable giving yourself an injection? If so, self-injections take only a few minutes, and you’ll have to do it weekly, every other week, monthly or every few months, depending on the biologic you choose. If you prefer the steady hand of a medical professional, you’ll only have to get infusions once a month to every six months, but the entire process can take a few hours each time.6. How much do biologics cost? Are they covered by insurance?Because biologics are the new, fancy kid on the block, they’re pretty expensive. Three months of biologic maintenance therapy, on average, costs nearly $12,000, according to a 2018 study published in The American Journal of Pharmacy Benefits.3 While doctors have had an easier time getting these drugs covered in the past few years, insurance companies sometimes limit which biologics they’ll cover, or make you prove that you have tried less expensive medicines first, like methotrexate or cyclosporine, both of which are immunosuppressive drugs, says Dr. Milam.If you have insurance and you’re having trouble getting your biologic medication covered, ask your doctor to write a letter of medical necessity to try to convince your insurance company that the drug is truly needed for your situation. If that doesn’t work, it’s worth looking into a medication assistance program. Many pharmaceutical companies offer these to help cover the cost of co-pays, which Moy has used successfully. These plans are sometimes called patient care programs, patient assistance programs, or patient support programs, which are designed to help lower or eliminate the cost of medications for those in need. Other options include prescription savings cards, advocacy groups, and non-profit organizations, all of which may be able to help you with financial assistance.If you don’t have health insurance, you can find Federally Qualified Health Centers that allow you to pay what you can afford for treatment. A few other places to start include: NeedyMeds for a list of available programs; The National Psoriasis Foundation for an overview of available options; and the Medicine Assistance Tool that can help connect you with a patient assistance program.7. How long do I need to take a biologic before I see an improvement?Some biologics, like the IL-17 inhibitors, work very quickly. “Within a few weeks, people might start to notice that their plaques are melting away and they’re starting to feel better,” Dr. Milam says. “But the 12-week mark is when you can expect to see the maximum benefit from most biologics.”When Wollschlager started on a biologic, the results were “almost instantaneous,” and he says he wonders why he wasted so much time covered in ointment. With that said, results can vary from person to person, so be sure to ask your doctor when you should check in if your medication doesn’t seem to be helping.8. How much improvement can I expect?This is where all that agonizing decision-making can pay off. Today’s biologics work so well that most people see significant improvement or even complete skin clearance. More than half of people who take newer generation biologics see 100% skin clearance within five months on the drug, according to a 2020 study published in the International Journal of Molecular Sciences.4

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