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Five things you should know about psoriasis

Psoriasis can be easily confused with other skin conditions, most often eczema. But there are simple ways to differentiate between the two.
Pediatric Dermatologist Ingrid Polcari, MD, who sees patients at University of Minnesota Masonic Children's Hospital, explains the difference between psoriasis and eczema.

Have a rash on the back of your elbows or on the front of your knees that won’t go away? It may be psoriasis, a common skin condition.

Psoriasis can be easily confused with other skin conditions, most often eczema. But there are simple ways to differentiate between the two. We asked University of Minnesota Health Pediatric Dermatologist Ingrid Polcari, MD, to explain how to identify and treat of psoriasis.

Polcari, who joined the University of Minnesota Health pediatric dermatology team in August 2012, has a special interest in procedural dermatology, including nail surgery and laser surgery. Earlier this month, Mpls.St.Paul Magazine recognized her as a "Rising Star" as part of the magazine's inaugural "Top Doctors - Rising Stars" edition. She was one of only 238 physicians in the Twin Cities area to be named to the list.

What are the causes, symptoms and any related complications of psoriasis?
Psoriasis is a condition that tends to run in families. There is no exact known cause, though streptococcal infections can trigger the condition in many cases, Polcari said. Psoriasis can arise at any time of life, though it most frequently occurs in your twenties and fifties. Psoriasis causes extra cells to build up rapidly on the surface of your skin. This build-up causes a skin rash that typically appears as ovals of scaly, dry skin accompanied by red patches that are itchy or sometimes painful. Psoriasis tends to involve the back of elbows and front of knees, but it can also involve other areas, like the scalp. Psoriasis is a long-lasting disease, though the symptoms and risks are limited to skin appearance and irritation. 

What are recommended psoriasis treatments?
Treatment depends on the area of the body involved and how much of the rash is present. When the rash is localized, topical treatments like lotions, creams, ointments and oils are often effective for patients. When the psoriasis is more extensive, a patient may want to consider other options like phototherapy, Polcari said. Finally, there are systemic medications available that work on the person’s immune system to control and resolve the rash.

Learn more about our University of Minnesota Health dermatology services.

What are the differences between psoriasis and eczema, and how can people distinguish between the two skin conditions?

Eczema tends to appear more in the folds of the elbows and behind the knees, as well as other places depending on the patient’s age. Eczema is extremely itchy, more than psoriasis. Eczema often affects patients who have other medical conditions, like seasonal allergies or asthma. Oftentimes, there’s a family history of eczema, allergies or asthma, Polcari said.

What’s the relationship between psoriasis and psoriatic arthritis?
Psoriatic arthritis can affect up to 30 percent of patients with psoriasis, which means there is swelling of the joints (typically the small joints). Usually, a first sign is a swollen finger or toe. The joints are said to be stiff or tight in the morning and they can get better throughout the day. Psoriasis and psoriatic arthritis usually develop five to 12 years after psoriasis starts, but sometimes it is the first or only sign a person has psoriasis.

When should you visit your doctor for psoriasis treatment?
If you have a rash on your body and you’re not sure what it is, that’s a good reason to have it evaluated. If you have a known psoriasis rash that’s not bothersome, it’s up to you. If it itches or it is psychologically distressing to you, then you can talk to your doctor about treatments. New evidence shows that people who have psoriasis have an increased risk of cardiovascular disease, even if they are not overweight. If you have psoriasis, you need to remain vigilant regarding your cardiovascular health, Polcari said.