1, first look at the degree of itching.
Eczema is generally itchy, eczema has water seepage, and itching is unbearable, because eczema is an allergic disease, as long as it is allergic, it will generally itch (except drug allergy).
Psoriasis (psoriasis) generally does not itch, or the degree of itching is relatively light. At this time, you may ask, what should patients with psoriasis do if they are allergic? Does it itch? Will there be a rash like psoriasis? Congratulations on your correct answer, because as long as it is allergic, it itches, and psoriasis has an isomorphic reaction, so there will be a rash similar to psoriasis. This will be discussed below.
2. Look at the shape of the rash.
The rash forms of eczema are generally papules, erythema, blisters, exudation, scabbing, mossy (thickening and hardening), chapped, desquamation and so on.
The rash forms of psoriasis are generally papules, erythema, lichenization, desquamation, pustules, inflammatory infiltration and so on.
It's easy to say, but it's really hard to tell. There is a trick here, that is, Auspitz's sign, that is, silvery scales are easy to peel off, film phenomenon and cribriform bleeding. What do you mean, that is to say, the white skin on the rash will fall off as soon as it is dug, and there will be a transparent film like plastic paper after the skin is peeled off. If you dig gently, there will be a little bleeding point when the membrane breaks, like a sieve.
This tool is the tool to distinguish eczema from psoriasis. Eczema and Auschwitz triad were negative; Psoriasis and Australopithecus triad were positive.
Some patients with chronic eczema have white skin in the rash, but it is not easy to remove. Dig hard and tear it. There is no ostwald triad.
There is also an isomorphic reaction, which means that after the skin is subjected to non-specific injuries (such as trauma, scratches, surgery, sun exposure, vaccination or some skin diseases), it can induce the same skin changes as the existing skin diseases. The skin diseases with isomorphic reaction include psoriasis, vitiligo, lichen planus and verruca plana. For example, if a patient with psoriasis is scratched, there will be peeling erythema on the wound, the needle eye of the injection will peel off, even the package bitten by mosquitoes will peel off, and if allergic, it will also be red and peeling on the allergic skin rash. This is the isomorphic reaction, and these rashes become psoriasis rashes.
3. Look at the distribution characteristics of the rash.
Eczema is distributed symmetrically in most cases, which can be scattered in all parts of the body, showing a chronic process and easy to relapse. Psoriasis is generally distributed along the hairline, that is, the scalp is along the hairline for a week, or only a part of the forehead hairline.
4. Look at the onset season.
Eczema has no seasonal law to follow, and it can happen all year round.
Psoriasis generally occurs in spring and autumn, and it is the most serious in winter. Summer is generally no problem, or it is lighter.
5. Look at the sweating function again
Eczema does not affect sweating.
Psoriasis patients generally do not sweat, or sweat less.
6. Observe the changes of nails
Eczema generally does not affect nails if it does not grow on fingers. Eczema at the edge of nails can cause nail deformation.
Psoriasis nails generally have pits, or nails are deformed and thickened. At first glance, it looks like onychomycosis, but compared with onychomycosis, psoriasis generally has ten nails deformed, and some are "thimbles", that is, there are pits on the surface of nails. Onychomycosis usually occurs on a few nails, and later it will spread to other nails.
7. Finally, take a look at these two disease scores.
Eczema can be divided into acute eczema, subacute eczema and chronic eczema.
Psoriasis can be divided into psoriasis vulgaris, erythrodermic psoriasis, pustular psoriasis and articular psoriasis.
Acute eczema with exudation is easy to distinguish. Erythrodermic psoriasis and pustular psoriasis both have fever, while articular psoriasis has joint pain or toenail deformation, which is easy to distinguish. The most difficult to distinguish is subacute eczema, chronic eczema and psoriasis. It's time to come up with important tools. According to the previous method, it is easy to distinguish them.