Psoriasis and Eczema Are Not Mutually Exclusive Diseases

Abstract

Background: Some reports have suggested that psoriasis and eczema are seldom found together. Knowledge of disease co-occurrence could lead to improved understanding of shared or opposing pathological mechanisms. Objective: We sought to determine whether psoriasis and eczema could exist simultaneously and consecutively in the same individuals. Methods: Skin examination data relating to 9,263 British children born during March 3rd to 9th, 1958 (the National Child Development Survey), were analysed for the co-occurrence of eczema and psoriasis. Results: Of 354 children with visible eczema at the ages of 11 or 16 years, 5 (1.4%) were also noted to have visible psoriasis, compared to 89 (1.0%) of 8,909 children who did not have visible eczema at 11 or 16 years. The relative risk of psoriasis in a case of eczema was 1.41, 95% confidence intervals from 0.58 to 3.46. Conclusion: Contrary to some hospital-based studies which have suggested that the two diseases are seldom found together, this study of a large and representative population suggests that eczema and psoriasis may co-occur concurrently and consecutively in the same individual.

Psoriasis in Swedish conscripts: time trend and association with T-helper 2-mediated disorders

“…The mean age at onset is 28 years and only 35% of patients with psoriasis are diagnosed before 20 years of age 31 . A prevalence of 0·5% in 18‐year‐old Swedish men is similar to the 0·8% reported at the age of 16 in the U.K 32 …”

Diseases Rarely Associated with Atopic Eczema

“…Among 1,701 patients with a firm diagnosis of atopic eczema, only five had concurrent psoriasis compared to an expected number of 125 patients. In contrast, a British study reporting from The National Child Development Survey of 1958 found an association between current atopic eczema and psoriasis at age 11 and 16 years [40]. These latter findings are consistent with the recent Scottish register-based study, which observed a strong association between current psoriasis and atopic eczema (the prevalence ratio of psoriasis in eczema patients was 2.88; 95 % CI 2.38 -3.45) [33].…”

“…The studies mentioned have several different limitations, including selection bias, which could be a serious and plausible limitation of the first study [15]; misclassification of diseases would be a plausible limitation of the two other studies [33,40].…”

PsEma—A Hitherto Unnamed Dermatologic Entity With Clinical Features of Both Psoriasis and Eczema

“…Eczema refers to a group of acute and chronic, superficial, pruritic, inflammatory skin disorders characterized histologically by inflammation, intercellular edema (spongiosis), vesiculation, and parakeratosis. Although some reports suggest the two conditions are mutually exclusive, 9,10 larger studies show that they can occur concomitantly 11–14 …”