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Diagnosis Pitfalls: Psoriasis vs. Eczema
Your Weekly Prompt to the Science of Skin and Success.
DFPC Team
April 17, 2025 • Estimated Reading Time: 4 minutes
Welcome back, DERM Community!
Last week, we explored Aging. If you missed it, be sure to check out that edition for a deep dive into its clinical types, management, and quality-of-life impact.
This week, we're zooming in on two of the most commonly misdiagnosed inflammatory skin conditions: Psoriasis and Eczema.
Their overlapping features can lead even experienced clinicians astray, especially when symptoms don’t present “by the book.”
Featured on This Week’s Chapter:
Meet Dr. Maria, a primary care physician seeing Lena, a 19-year-old with chronic itchy patches in the flexural folds of her arms.
Lena has a family history of asthma and allergies, and her symptoms worsen in winter. The skin is dry, red, and lichenified.
Compare this with Carlos, 35, who presents with symmetrical, silvery plaques on his scalp and elbows and some changes in his fingernails.
These two cases highlight how age, distribution, history, and morphology help us distinguish between Psoriasis and Eczema.
🧑⚕️Psoriasis vs. Eczema – Quick Comparison Table
Feature | Psoriasis | Eczema (Atopic Dermatitis) |
|---|---|---|
Age of Onset | Teens–30s (variable) | Infancy or early childhood |
Itch | Mild to moderate | Intense, often primary symptom |
Distribution | Extensor surfaces, scalp, lower back | Flexural areas, neck, eyelids |
Scale | Thick, silvery-white | Thin, flaky, often less defined |
Nail Involvement | Common (pitting, ridging, onycholysis) | Rare |
Family History | Psoriasis, arthritis | Atopy (asthma, allergies) |
Triggers | Trauma, stress, infection, meds | Irritants, allergens, temperature shifts |
🧑⚕️Psoriasis vs. Eczema – Clinical Signs
🧴 Psoriasis vs. Eczema: Diagnostic Infographic
Struggling to quickly differentiate between Eczema and Psoriasis during consults? We’ve got you covered.
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Download our FREE Psoriasis vs. Eczema Diagnostic Infographic. Perfect for quick reference during patient encounters or teaching sessions.
Want to learn more about treatments? Get the best tips for you and your patients here.
Opportunities for Dermatologists: Grow Your Career
👋🏻 See you next Thursday, DERM community!
Thanks for joining us in this week’s edition of Beneath the Surface.
Spotting the differences between psoriasis and eczema isn’t always easy, but understanding the subtle clinical clues, patient history, and presentation patterns makes all the difference.
Together, we’re reducing diagnostic errors and bringing clarity to confusing skin conditions, helping patients feel heard, understood, and properly treated.
💬 Got a condition or topic you want us to cover next? Drop us a line!
Stay curious, stay compassionate: your attention to detail changes lives
— The Derm for Primary Care Team
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