WEDNESDAY, July 20 (HealthDay News) -- Psoriasis and eczema both
cause red, scaly skin rashes, but the similarities between the two
common, distressing conditions typically end there.
And now, examining patients suffering from both ailments (a very
rare phenomenon), German scientists have teased out the opposing
immune system responses that prompt skin flare-ups for both
They believe the findings could one day lead to more targeted,
The study, published in the July 21 issue of the
New England Journal of Medicine, evaluated three patients with both psoriasis and eczema and noted that the T-cells -- types of white blood cells that fight infection -- found in psoriasis lesions differed from those found in eczema lesions.
The findings suggest that these T-cells migrate to the skin in
response to distinct environmental triggers,
not that the skin cells themselves are abnormal in either
inflammatory condition, the study authors said.
"It's just another way for doctors to understand immune pathways and where they go awry," explained Dr. Doris Day, a dermatologist at Lenox Hill Hospital in New York City, who was not involved in the study. "It puts our understanding exponentially ahead and confuses us at the same time, because it's not supposed to happen [that patients can have both conditions]. The study definitely has value, and they're not making any claims or recommendations."
The most prevalent autoimmune disease in the United States,
psoriasis affects up to 7.5 million Americans and is thought to
arise from a combination of genetic and environmental triggers,
according to the National Psoriasis Foundation. Eczema, on the
other hand, is thought to be an allergic response and often occurs
simultaneously in those with asthma or food allergies, according to
the American Academy of Allergy, Asthma and Immunology. It is often
outgrown by adulthood.
Psoriasis lesions in the study participants contained large
numbers of so-called Th1 and Th17 cells, whereas eczema lesions had
higher amounts of Th2 and Th22 cells. The researchers expanded
their testing to include five patients with psoriasis and skin
allergies to nickel -- a much more common combination that prompts
an eczema-like reaction -- to confirm a similar T-cell response to
The study also found that all eczema lesions, but none in
Staphylococcus aureus bacteria, confirming that T-cells in
psoriasis appear to prompt an innate immune response that's
different from what is seen in eczema.
Dr. Jerry Bagel, a spokesman for the National Psoriasis
Foundation and associate clinical professor of dermatology at
Columbia University in New York City, said the research indicates
that eczema and psoriasis "are clearly distinct entities, but there
is some crossover immunologically."
If scientists could determine which antigens stimulate each
condition -- a job that would likely take years -- they might find
new ways to stop the disorders from developing in predisposed
people, Bagel and Day agreed.
Current psoriasis treatments, which include both topical and
systemic drugs, aim to suppress the body's immune response and slow
down the skin cell growth cycle that leads to its trademark red,
scaly plaques. Eczema treatments can involve both medications and
lifestyle changes that cut itching, inflammation and worsening of
But, perhaps in the future, "they could have more direct testing
to see if patients have an immune system alteration," Day said.
"The more we understand the pathways and how the immune system
responds to insults from the external world . . . we can adjust
steps along the way, or medications that minimize side effects and
Find out more about eczema and psoriasis at the
International Eczema-Psoriasis Foundation.
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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