Questions and Answers
Questions and AnswersDate: 8 Mar 2000 08:07:27 -0500
1 Psoriasis vs. eczema Thank you in advance for responding. I have a 9 yr. old daughter with a skin disorder. She has seen dermatologist and an infectious disease doctor and we have been told that she has eczema and/or dermatits. Her S/S are: red, extremely dry, cracking areas on her fingers. No puritis associated with this and her pain comes from the tightness and cracking from the skin. Her fingernails have ridges and the base of her fingernails are becoming very damaged. There appears to be a thickening of skin under her fingernails and a lot of flaking. I do not notice the silvery look as I have read about regarding psoriasis, nor do the pictures I have seen of psoriasis portray her disorder. She has been given topical steroids which seem to minimally help. She usually has it only on one hand at a time and only on the fingers and fingernails. Just tonight however, I noticed an erythematous, dry patch on the back of her hand, and now a spot on a toe and toenail. She is starting to become very self concious and teary eyed and I would like to have a diagnosis. My father was diagnosed in 1972, while on his death bed, with pemphigus vulgaris., What scares me is that he was diagnosed with psoriasis, eczema, allergies etc... It took 4 yrs. to diagnose his pemphigus. What are distinguishable characteristics for psoriasis vs. eczema? Do we need to pursue larger institutions for a definitive diagnosis? Any information you can relay would be greatly appreciated. ANSWER BY A. Van Beveren, Ph.D.,CNS,CNC http://idt.net/~drv As Dr. Cheraskin so eloquently stated: "The name of the game is the name". Add the insurance factor and the name of the game is the name and the code. Now add the surgical factor and the name of the game is the name of the correct body part.... (hopefully). In the traditional practice of medicine disease does not exist until a textbook diagnosis is found - possible when a constellation of very obvious findings ripen. A diagnosis is established only when all the relevant signs and symptoms (criteria) are met and present at the same time in order to form the cluster we all agree on and recognize: hence the "diag-nosis". I expect my clientelle to solicit a minimum of two first opinions and never, ever, a second one. Acute or chronic drug use distorts the clinical picture. When one or more of the "necessary" signs or symptoms are missing, some diagnosticians, not able to di-sect their criteria into subclinical, physiological and biochemical entities, are thus unable to recognize or modify their criteria to reflect possibly toxic or deficient nutritional status. Many, instead, use their prescription pad to prescribe mind-altering drugs - or worse - call you crazy! Fortunately the differential diagnosis between eczema and psoriasis is easy and most dermatologist (with sensitive fingertips) should be able to tell the difference with their eyes closed. That's how I learned it anyway. But it sounds like it might be complicated by candidiasis and modified by steroids. See your local holistic physician. !====================================== DISCLAIMER: The material contained here should not be considered a substitute for a physician. These are only general guidelines to help you think about the medical possibilities. You are encouraged to consult your own health care provider with any questions or concerns you may have regarding your condition. Ask the Doctors website is at http://www.flora.org/ask-doctor/.