Skin is the body’s largest organ, and it isn’t immune from its own set of potential health issues.
While acne, warts and moles make up the largest chunk of skin-based problems seen by area health professionals, there have been a number of cases involving psoriasis, eczema, impetigo and ringworm.
These four conditions are not related in cause, but do have some similarities in how they present themselves, treatment options and ways to potentially prevent them.
“This is a big topic you could write a story on by itself. There is a lot of uncertainty about psoriasis,” said Dr. Matt Meeker, of UPMC Susquehanna.
“On the molecular level, researchers are not really sure what it is and what causes it,” added Dr. Howard Pride, of Geisinger. “Its common, although not as common as other skin issues. About two percent of people get psoriasis where, in perspective, 20 percent of children develop eczema at one point or another.”
The condition causes thick, reddish plaques on the skin, usually around the elbows, knees and behind the ears, according to Meeker, but it can affect anywhere.
“There are red, scaly patches with white regions. They can develop on the scalp, genitals and other regions, too,” he said.
In some cases, it can create changes in the nails, making them look pitted and crumbly, Meeker added.
It is more common in adults, but Dr. Pride has seen it pop up in newborns at times, too.
“It has some genetic basis in that about 50 percent of people with psoriasis have a family history of it — but, of course, that means that 50 percent have no family history,” he said.
“It presents in different ways in different people — it can be in the classic elbow and knee region on one person, only the hands and feet of another and then another patient can be covered from head to toe.”
Treatment involves using topical anti-inflammatory creams and ointments, “however, if the lesions are extensive over the body, the patient may need to take steroids in pill form or even through shots,” said Meeker. “In some cases, light therapy can be helpful, too.”
Psoriasis can be a long-term issue for many who get it, according to Pride.
“It is basically a lifelong process for many people, especially those who get it young,” he said. “At times, it gets better, and then other times it is worse, but it rarely completely goes away. It is a condition we treat more than cure.”
Another skin condition with a mysterious origin, it presents as more of a red scaly set of splotches that are less well defined than psoriasis, Pride said.
“Where psoriasis is more typically associated with being on the tops of elbows and knees, eczema tends to be found in the inside of the elbow and knee joints,” said Pride. “At times, though, it can look very similar to psoriasis and it can be tough to distinguish between the two.”
“It can come in a wide variety of presentations. It can start with little bumps and evolve into dry, flaky skin,” he said. “It is usually associated with dry skin, and doesn’t usually develop the thick plaques of psoriasis.”
Both doctors admitted that eczema has been connected to seasonal allergies and asthma.
“Part of the theory is that things start with bad skin via the eczema, which then allows certain allergens to enter the various systems in the body, but that is just a theory and isn’t proven,” Pride said.
Treatment is similar to psoriasis, with an emphasis on moisturizing the skin.
“Over the counter moisturizing creams can help,” Meeker said. “It can also help to avoid taking overly hot showers and to dab off with your towel afterward instead of wiping the skin. Sometimes, an antihistamine can be helpful if the eczema is brought on by allergies.”
Unlike psoriasis and eczema, impetigo is a skin infection caused by bacteria and it is contagious via skin-to-skin contact.
“It is an infection of the skin that is often staph-caused, that causes superficial blistery and pussy lesions,” said Pride. “It leads to a yellowish, honey-colored crust, and the edges — because they overlap typically — can look like scallops.”
The condition is more common in younger children, and typically manifests around the mouth, hands and other extremities, according to Meeker.
“It is more common in warmer, humid weather during the summertime when bacteria gets into cuts, scrapes and other minor abrasions,” he said.
Topical antibiotic cream is usually the first line of treatment if the surface area of the infection isn’t too large, in which case oral antibiotics can be used.
“Good hand washing and hygiene in general is important to help prevent this sort of condition,” said Pride, who added it can be transferred not only via skin-to-skin contact, but also via shared objects such as towels, sports equipment, etc.
Like impetigo, ringworm can be highly contagious, but ringworm isn’t caused by a bacteria. Instead, the condition, which has nothing to do with worms, is triggered by a fungal infection.
“Ringworm is basically athlete’s foot on the body,” Pride said. “It is more red and scaly compared to the oozing and crustiness of impetigo.”
“It causes raised, ring-shaped lesions with a small clearing in the middle,” added Meeker. “It isn’t caused by cuts and scrapes that get infected, but more often from unclean floors, pools and shower stalls.”
Ringworm is pretty highly contagious via skin-to-skin contact or even via shared items, which is why the condition is associated at times with wrestlers who use the same wrestling mats that can be damp.
“If the skin is dry, it is not as susceptible, so we recommend using powder between toes and skin folds,” Pride said. “Wrestlers or football players shouldn’t participate if they have it until it is properly treated.”
Anti-fungal treatments are the norm with ringworm, including a number of over-the-counter options.
“Basically, anything that treats athlete’s foot will work on ringworm on the body,” said Pride.