What’s That Rash?

by Mel on November 24, 2009

How do you know what your rash is?

The answer is simple – you have to ask your doctor.  Only a doctor can give you a definite diagnosis.  However there are some typical characteristics that may help to give you a clue.

Eczema and Psoriasis are two rashes commonly confused

Eczema and Psoriasis are the most common rashes I get asked about and whilst they have many similarities they are distinctly different conditions.

Both eczema and psoriasis are chronic inflammatory skin conditions, ones that persist for a long period of time and they tend to run in families.  As with any chronic condition it is important to look at your lifestyle and understand how various aspects of it may affect your skin.  Unfortunately there is no known cure for psoriasis and eczema, but they can be managed.

Eczema, the itch that won’t go away

Eczema is most common in children but can affect any age group, both male and female. The most distinguishing feature of eczema is the unbearable itch.  Typically eczema skin is very dry and the lesion is red and scaly.  It usually appears on the face, neck and arm and leg folds but can appear on the whole body.

Eczema tends to run in families with the likelihood of a child developing eczema increasing significantly if one or both of the parents has ever suffered from eczema, asthma or hayfever.  Eczema is allergy based and it is these allergies that will trigger an eczema flare up.

The silvery scales of psoriasis

Psoriasis on the other hand is the result of an over production of skin cells.  The predisposition to develop psoriasis is passed on along the family line however it is environmental triggers that will result in an outbreak of the condition.

The psoriatic lesion is usually a discrete, bright red patch covered with silvery scales.  The lesions may be itchy but unlike eczema this is not a distinguishing feature.  Psoriasis usually affects the scalp, knees, trunk and elbows.

It is rare for a child to develop psoriasis.  The condition usually first appears in the late teen or early adult years.  Both males and females can be affected equally.

Whilst it is the itch in eczema and the silvery scales in psoriasis that are the distinguishing characteristics the only way to know for sure is to visit your doctor and have a proper medical diagnosis.

Eczema or Dermatitis

There is a good deal of confusion over the difference between eczema and dermatitis.  They both broadly mean skin inflammation.  Many doctors use the two terms interchangeably.

If you have atopic eczema, it is the same as having atopic dermatitis.  If you have irritant contact eczema it is the same as having irritant contact dermatitis. The condition is the same, therefore the treatment is the same.  It is just a matter of varying terminology being used by different medical practitioners.

Is it fungal?

Eczema and psoriasis are inflammatory skin conditions.  They are not fungal infections. Ringworm is a fungal condition characterised by itchy, red, scaly, inflamed circles that spread outwards leaving pale skin in the centre.  The appearance is not unlike the healing lesion of nummular (discoid) eczema.

Although similar in appearance the two conditions are not at all related.  It is important to establish if you have an inflammatory skin condition or a fungal condition before you start treatment as the treatment is quite different and eczema treatments may feed fungal infections making them worse.

Not fungal or inflammatory

Rosacea is a chronic condition affecting the blood vessels of the face.  The superficial facial blood vessels become enlarged and dilated resulting in the hot, inflamed rash that is common to this condition.  Rosacea is triggered by any condition that will cause the blood vessels to dilate.

It is important to remember that rosacea is not related to eczema or acne and the treatments normally used for these conditions may worsen rather than improve the symptoms.  Treatment is aimed at treating symptoms and avoiding trigger situations.

What to do

In order to prevent worsening of a skin condition it is important that any treatment options are selected for the condition that you have.  An accurate diagnosis of any rash can only be made by a medical practitioner.  If you are unsure of what your rash is consult your doctor before starting treatment.

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