Itchy and scaly

Dear Dr. Jen,

For several months now, my scalp and my skin have been itchy and scaly.  I’ve been to a dermatologist and an allergologist.  I was diagnosed to have psoriasis or eczema.  I’ve been on and off steroids for a while.  Please help!  I’m starting to lose my hair and I am so frustrated.  How can you differentiate both skin conditions when it seems to look exactly alike?

Bebot

Dear Bebot,

Eczema and psoriasis can be mistaken one for the other.  It can both be red, itchy rashes with some scaling on the surface.  While giving oral steroids to eczematous skin may be helpful, it is best to stay away from oral steroids if you have psoriasis.  Allergies should also be ruled out.  Skin prick test, patch testing and blood testing can help find out any allergies that you may have. If your doctors are confused with the diagnosis, it may be time to do a biopsy.

A tiny punch biopsy, about three millimeters in diameter will be performed as an out- patient procedure.  It is a quick and very tolerable procedure.  Results can come in days to weeks. This will objectively differentiate between the two diagnoses and put your mind at ease.  The sooner it is done, the easier it is to narrow down the treatment options that may be best for you.  Both conditions can also coexist in a person and may not necessarily be exclusive of the other.

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Dear Dr. Jen,

My baby has rashes on her chin.  She just turned seven months old so I’m wary of any strong medication.  I’ve tried using diaper rash cream but it hasn’t helped much.  Please advice.

Suzie

Dear Suzie,

Judging from the age of your baby, two things might be happening.  First, it is the age when they teeth.  This usually means production of excess saliva.  Too much drool can definitely irritate the corners of the mouth as well as the surrounding area.

Scondly, seven months old is also the age after babies start taking in solid food. It can also be an allergy to a food that your baby was just exposed to. Treatment for either condition include keeping the area dry and clean at all times.  Wiping saliva with a moist, clean cloth is enough to keep it clean.  Don’t use any wipes with alcohol or scent that may irritate the skin more.  And as long as there is no yeast infection present, you can apply a mild anti-inflammatory for a few days just to get the rashes out.