Psoriasis and Eczema

In Chinese Medicine, the categories of the diseases may follow in different places than Western textbooks. This means that two cases of eczema and psoriasis which both look and feel inflamed and itch will be treated more the same than two cases of psoriasis in which one is pale and the other red and inflamed.

Psoriasis and eczema may look very much alike. In Chinese Medicine we treat them with the same principles but some variations.

Psoriasis – 白疕 báibǐ means “white sores”

Psoriasis in an auto-immune disease which means it usually is harder to “cure” completely. It usually has white “scales” which are the result of the overproduction of skin cells that then collect on the surface. It may be very itchy and may bleed in “punctiform hemorrhagic spots” underneath as it is scratched or the scales removed.

Psoriasis may affect younger patients and may get worse during the winter and better in the summer and thus psoriasis responds favorably to (sun light- UV) light therapy.

Psoriasis can appear anywhere on the body but most often on the elbows and knees is common but can also be on the scalp where it becomes more difficult to treat. It is not contagious.
Psoriasis occurs because normal skin regenerates every 3 weeks and psoriatic skin regenerates in a week. This leaves a surplus on the surface that is uncomfortable but generally doesn’t itch so badly. The defining factor is the appearance of blood spots when the scales are taken off the surface of the body.

The most common type of psoriasis is called Plaque Psoriasis or Psoriasis Vulgaris.
A less common form is Psoriatic Arthritis, which as its name implies, comes with swollen joints usually confined to the fingers and toes but may spread to the spine. This can lead to very severe cases and may take patience to endure and to treat.
Erythrodermic psoriasis often comes from the topical use of corticosteroids.

Eczema – 湿疮 shichuāng is also known as dermatitis 皮炎 píyán (pí means skin and yán means scorching hot). The English word come from the Greek ekzema and means “something thrown out by heat.

While psoriasis is auto-immune, eczema is considered an allergic reaction. The skin rash is patchy or may be diffuse without clear edges to it. It is often bilateral indicating a systemic issue. It is often made worse if not caused by greasy foods. As such in the beginning the psoriasis may ooze fluids while chronic cases may be more dry and cause lichenification (becomes hard, dry and leathery).

Because eczema is an allergic reaction it is often associated with asthma. Children with eczema often develop asthma and adults with eczema often had childhood asthma.

Eczema/ dermatitis can be broken down into three types:
1) Contact eczema, as its name implies, comes from contact with an allergen such as a plant (poison ivy as a severe case), metals such rings and bracelets, fragrances and other chemicals.
2) Atopic eczema is a more generalized sensitivity that may be inherited. Many allergens in the general environment or in Chinese Medicine, the internal environment of heat and dampness may cause the eczema. It obviously is harder to treat than a contact eczema where the source can be more readily identified and then removed.
3) Irritant Eczema is much like contact eczema in that it is caused by clothing or work habits to a recurring irritant. This might be straps on a bra or too tight underwear and the skin becomes chaffed. Also being in the wind may dry out the face and lips.

Eczema shows up all over the body but particularily:
A) around and in the ears
B) scalp – this can get very bad and may tangle the hair, ooze and cause yellow scabbing
D) breast and nipples – usually more in females.
E) umbilicus (belly button)
F) Hands and fingers
G) Scrotum
H) Legs
I) “coin shaped” may appear in spots- round spots often surrounded by smaller spots, may be be red and itch severely.