Psoriasis Appearance, diagnosis and treatment


Without a medical diagnosis, an individual may not know if they have psoriasis or skin infected with the scabies mite. Both conditions can look and feel similar, although there are clear differences upon closer inspection.

This article explores the differences between scabies and psoriasis, including the appearance, symptoms, treatments, and prevention.

Appearance

Although scabies and psoriasis can seem similar, there are ways to tell the difference by looking at the skin’s appearance:

Scabies appearance

Microscopic mites that burrow into the skin cause the contagious skin condition called scabies. The female mites burrow into the epidermis, or outer skin layer, and lay eggs.

Scabies causes a rash to appear on the skin. Under a magnifying glass, a person might also notice curly lines on the skin where the mites have burrowed in.

These burrows can appear in the following places:

  • fingers
  • wrists
  • elbows
  • armpits
  • genitals
  • breasts

In older adults or infants, they can also appear on the head and neck.

The skin may weep, become flushed, and have areas of inflammation.

Learn more about the appearance of scabies bites here.

Psoriasis appearance

Psoriasis is a chronic, autoimmune skin condition that is not contagious. It can occur on any part of the body, including the:

  • face
  • hands
  • soles of the feet
  • armpits
  • joints

Psoriasis is a condition with various sub-types, the most common being plaque psoriasis.

Psoriasis causes patches of thickened skin with silvery-white scaling known as plaques.

The skin may also redden and become irritated and inflamed.

However, the appearance of psoriasis can vary according to a person’s skin tone.

Learn more about what psoriasis looks like on Black skin here.

Symptoms

A person can also use symptoms to tell the difference between the two conditions:

Scabies symptoms

Scabies has two primary symptoms:

Raised spots and rash

Scabies causes raised spots or a rash that forms in lines along the skin where the mites have burrowed.

Itching

The body’s allergic reaction to the mites causes intense itching.

Itching may be more frequent during the night and can disrupt sleep.

Learn more about the symptoms of scabies here.

Psoriasis symptoms

Symptoms differ between the types of psoriasis but can include:

  • skin fissures or cracks
  • pain
  • bleeding
  • thickened areas of raised skin
  • itching or burning sensation
  • dryness or redness
  • fine scale-like texture
  • pitted, cracked nails

Pus filled bumps

Pustular psoriasis makes up around 3% of psoriasis cases. It causes pus-filled bumps and areas of inflammation.

Learn more about the symptoms of psoriasis here.

Diagnosis

There are differences in how doctors test for the skin conditions.

Scabies diagnosis

Doctors can usually diagnose scabies from its characteristic appearance.

A doctor can confirm the diagnosis by taking a sample of the burrow by scraping the skin. The doctor can then use a microscope to identify mites or eggs invisible to the naked eye.

Psoriasis diagnosis

A general doctor or dermatologist carries out a physical examination of the skin to diagnose psoriasis.

They will also take a medical history to find out if the individual has close family members with psoriasis, as psoriasis may be hereditary.

Treatment

Doctors will give a person different treatment depending on whether they have scabies or psoriasis.

Scabies treatment

To treat scabies, doctors can prescribe scabicides that kill both the mites and any eggs under the skin. An example of a scabicide is Elimite.

Individuals taking Elimite must apply the scabicide to their entire body, from their head down to the bottom of their feet. They should leave the treatment for 8–14 hours and wash it off in the shower or bath.

If any sores have become infected due to scratching, the doctor may also advise antibiotics.

Learn about the best ways to treat scabies here.

Psoriasis treatment

Treatment options for psoriasis will depend on the severity of the condition. Most people with psoriasis apply topical creams such as moisturizers, steroids, or coal tar preparations directly to the skin to alleviate some of the symptoms.

Some doctors may treat moderate to severe psoriasis using a systemic medication, such as a biologic. An example of a biologic used to treat psoriasis is Cimzia (certolizumab pegol).

If treatments are ineffective, or the psoriasis is severe, a doctor or dermatologist may recommend UV light therapy or oral anti-inflammatory medication.

Learn about home remedies for psoriasis here.

Prevention

A person can take different measures to try to avoid contracting scabies or exhibiting symptoms of psoriasis.

Scabies prevention

A person can prevent scabies by avoiding skin-to-skin contact with infected individuals, as the condition is highly contagious.

Scabies is more prevalent in locations where numerous people are in close contact where it can spread more readily.

Scabies can be challenging to prevent because an infected individual may not show external symptoms such as itching or a rash for 4–8 weeks and can unknowingly pass on the mites.

Learn more about preventing scabies here.

Psoriasis prevention

Researchers are not yet sure of what causes psoriasis. However, genetic and environmental factors can play a role.

People also should avoid the factors that may cause or worsen psoriasis, such as:

  • mental stress
  • infection
  • trauma
  • damp or humid conditions
  • drug use
  • drinking alcohol
  • smoking
  • UV exposure

Individuals who smoke should aim to cut down or entirely quit smoking. One 2016 study confirmed a link between smoking and psoriasis, and smoking can interfere with immune system function.

Learn about how to prevent psoriasis flareups here.

Outlook

Scabies can go away with medication, while psoriasis is a chronic condition.

Scabies outlook

Treatment for scabies must involve medication such as a scabicide cream that contains permethrin.

Usually, one round of this treatment is necessary to kill the mites.

The individual may experience itching or discomfort after treatment. If a person continues to experience itching after 4 weeks, they should contact their doctor.

Once the treatment has finished, scabies will not come back unless a person comes into contact with the mites again.

Psoriasis outlook

Individuals with psoriasis need a management strategy as it is a chronic disease with no cure.

People with psoriasis are prone to flare-ups with a reappearance of or worsening symptoms.

Managing external factors such as stress levels can help prevent flareups.

Wearing loose clothing and moisturizing regularly can also help individuals manage their psoriasis and remain comfortable enough to go about regular daily activities.

Scabies and psoriasis vs. eczema

Both scabies and psoriasis may cause similar symptoms to eczema. Eczema is a form of skin irritation.

Scabies vs. eczema

Although scabies is caused by parasitic mites and is highly contagious, people can treat it by using prescribed scabicide creams.

Eczema is chronic, non-contagious, and managed by using corticosteroid creams and other ointments.

Learn more about the difference between scabies and eczema here.

Psoriasis vs. eczema

While both psoriasis and eczema cause flushed, itchy skin, they can differ slightly in appearance, and have different causes and treatment options.

Like psoriasis, eczema does not have a cure, but a person can use treatment in the form of creams, or oral medication, such as systemic corticosteroids, to ease symptoms.

Learn more about the difference between psoriasis and eczema here.

Scabies and psoriasis vs. hives

Hives are also known as Urticaria.

If the hives lasts 6 weeks or less, it could be the result of allergies.

A response to an allergen causes the release of histamine. In turn, this causes a sudden skin outbreak of swollen, pale red bumps and plaques.

Because many different triggers release histamine, it may be difficult to pinpoint the cause of hives.

If hives lasts longer, it may be chronic, and not have an underlying cause.

Scabies vs. hives

Hives can appear quickly.

Scabies takes a longer period, often several months, before an individual discovers they have an infection.

Psoriasis vs. hives

Psoriasis will give a person scalier lesions, whereas hives may cause smoother bumps on the skin.

The smooth welts that come from hives may be large. Psoriasis may cause large patches of dry, cracked skin.

Learn more about hives here.

Summary

Scabies is a parasitic mite infection of the skin, whereas psoriasis is a chronic inflammatory skin condition.

The two conditions can have similar appearances and symptoms. However, it is possible to tell the difference.

Individuals may not know they have scabies and can pass it on to others in close contact. Avoiding skin-to-skin contact with infected individuals can reduce the likelihood of an infestation. A prescribed scabicide can successfully treat scabies.

Psoriasis requires long-term management, lifestyle changes, and medication to alleviate symptoms and prevent future psoriasis flare-ups.

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