Difference between psoriasis and eczema

July 20, 2010

Question: What is the difference between psoriasis and eczema?

Answer: Psoriasis and eczema are both skin diseases in which the skin is inflamed. The lesions of psoriasis tend to be a deeper red and thicker, have sharper borders and a more silvery scale. The lesions of eczema tend to be thinner, more diffuse, and are related to either allergy or sensitivity of the skin. Sometimes it is difficult to tell psoriasis from eczema, especially on the hands. Many of the treatments for the two conditions are the same, however, because therapies that reduce inflammation in the skin will often treat both conditions.

Steve Feldman, M.D., Ph.D., is professor of dermatology at the Wake Forest University School of Medicine in Winston-Salem, N.C. He is a long-time volunteer with the National Psoriasis Foundation.

Dr. Feldman is the author of “Compartments: How the Brightest, Best Trained, and Most Caring People Can Make Judgments That are Completely and Utterly Wrong” available at Amazon.com and BN.com. He is also host of “Getting Better Health Care” on webtalkradio.net.


  • Dear Dr. Feldman: Remicade completely “cured” my psoriasis in about 3 months. My skin became free of plaques. I then decided to discontinue Remicade and started on Enbrel, for convenience. Enbrel did not work for me, and I erupted in a tremendous flair of pustular psoriasis on my hands and feet, plus plaques everywhere that they had not previously been. I have been back on Remicade every 4 weeks for 4 months, and my lower legs are still very reddened, even though the plaques are thin, and appear to be breaking up. Soriatane “cured” the pustular P., and I have no more plaques except for my lower legs. I call them my “pink knee socks”. I am a healthy, trim, 55 year old nurse, with no other co-morbid conditions. There is no psoriasis in my family that we know of, but eczema is common, and I had that for a short time when I was a kid. I have been checked for M.F. lymphoma. My question is, why is it taking so long for Remicade to rid me of my pink knee socks? Should I be more patient, or could it be the Remicade will no longer be effective? I am on 6 vials every 4 weeks for 135 pounds. My Derm is an M.D/Phd from Harvard, and biologics are his specialty. I trust his treatment plan, but I am curious about a second opinion. I was diagnosed with psoriasis 18 months ago. I tried Amevive, PUVA lights and ointments before going on Remicade. Your thoughts are appreciated.

    Has anyone else experienced ‘pink knee socks?’

  • I have had psorisis/ eczema (not sure wihich) in my ear and the back of my head…I think I have tried everything over the counter including nutragena shmpoo! This began about 6 months ago after I started taking levythroxine. What should i do..I have stopped taking the levythroxine and it has become a little better…Could I be allergic to the med?

  • Hi there Pam: certain medications can trigger psoriasis in some folks. But in many cases, psoriasis triggers are not universal. You can read about some commonly identified psoriasis triggers here: http://psoriasis.org/about-psoriasis/causes.

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