Lupus and psoriasis are both chronic conditions that share many similarities, but do have their own unique differences that set them apart. Psoriasis is far more common than lupus, affecting 125 million people worldwide –compared to only five million people affected by lupus.
Lupus and psoriasis both cause rashes, and the facial rash in psoriasis often mimics the malar rash commonly seen in lupus. This is where it can be confusing to diagnose lupus and psoriasis right off the bat. The malar rash – butterfly rash – typically covers the face, more specifically, the cheeks and the bridge of the nose in a somewhat butterfly pattern.
Although usually not painful, this rash can become quite itchy and lead to psychological and emotional distress for the patient depending on the location.
Immune system plays a large role in lupus and psoriasis. In both conditions, it creates autoantibodies to mistakenly attack healthy tissues – hence, both conditions are autoimmune diseases.
Here we will outline the differences and similarities between psoriasis and lupus from symptoms to causes as well as treatment and prevention of future flare-ups.
Lupus and psoriasis connection
Lupus and psoriasis share many similarities, often complicating the initial diagnosis. For starters, the two are idiopathic, meaning, the exact cause is unknown. Both conditions are not contagious, both produce antibodies that cause inflammation and tissue damage, both are related to arthritis and produce arthritis-like symptoms, both can cause damage to the brain, kidneys, and lungs, and both have been linked to environmental, genetic, and hormonal triggers.
The biggest connection between lupus and psoriasis is what is known as “isomorphic response,” which is when one disease can initiate another disease in the body.
Differentiating Psoriasis and Lupus
|Overview||Chronic, autoimmune disease that can damage any part of the body.||Autoimmune disease characterized by patches of abnormal skin.|
|Prevalence||Estimated 1.5 million cases in America.||Approximately 2 percent of Americans experience psoriasis.|
|Gender||Affects women aged 15 to 44 more than men.||Affects both sexes equally.|
|Affected body parts||Affects almost any part of the body, especially skin, blood, joints, kidneys, heart, lungs, and brain.||Most commonly appears on the scalp, knees, elbows and torso.
Less frequently on the nails, palms, soles, genitals, and face.
|Symptoms||Fever, fatigue, swollen joints, hair loss, facial rash, chest discomfort when taking deep breaths||Red patches of skin, dry, cracked skin, itching, burning, swollen and stiff joints|
|Causes||Combination of genetics, environmental factors.
Potential triggers exposure to sunlight, infection, certain medications
|Triggered by a skin injury, emotional stress, infections, and certain medications|
|Complications||Kidney damage, blood problems like anemia, inflammation of the lungs and heart, increased risk of infections, cancer, bone tissue death, and pregnancy complications||Psoriatic arthritis, eye disorders, type 2 diabetes, high blood pressure, Parkinson's disease, and kidney disease|
|Diagnosis||Laboratory tests, imaging tests, biopsies, kidney and liver assessments, urinalysis, and antinuclear antibody test||Physical exam, examination of your skin, scalp, and nails, skin biopsy|
|Treatment||Avoiding triggers like sunlight, paying attention to your diet, exercising regularly, recording your symptoms, and documenting the triggers||Topical ointments, oral medications, injected medications, light therapy|
Psoriasis vs. lupus: U.S. prevalence and economic impact
Approximately two percent of Americans experience psoriasis, which can begin at any age. For the most part, the first onset tends to take place somewhere between the age of 20 and 30, and second onset is usually at 50 to 60 years old. Currently, about 7.5 million people in the United States have some form of psoriasis. Some of them experience joint inflammation, which leads to psoriatic arthritis. Close to 90 percent of people with psoriasis get what is referred to as “plaque psoriasis”. These are patches of raised, reddish skin covered with silvery-white scales. There are other forms, including a type of psoriasis that can be found under the fingernails.
It is estimated that lupus accounts for about 1.5 million cases in America, and affects at least one in five individuals worldwide. Lupus affects women aged 15 to 44 more than men. The economic impact of lupus in the U.S. is $12,643 per patient and $8,659 in lost productivity.
Psoriasis and lupus difference: Signs and symptoms
Not every lupus patient experiences the same symptoms, but there are some common ones all patients may encounter. Lupus symptoms come on slowly and may be temporary or chronic. Many patients will experience a flare, which is a symptom spike.
Lupus symptoms vary, depending on the affected body part or organ. Some common symptoms of lupus include:
- Fatigue and fever
- Joint pain, stiffness, and swelling
- Butterfly-shaped rash on face
- Skin lesions that worsen due to sun exposure
- Fingers and toes turning white or blue in the cold or during stress
- Shortness of breath
- Chest pains
- Dry eyes
- Headaches, confusion, or memory loss
Psoriasis symptoms appear anywhere on the body, even the scalp, fingernails, and toenails. Symptoms of psoriasis include:
- Dry, cracked skin that could bleed
- Soreness on spots
- Burning or itching sensation
- Thick, ridged, or pitted fingernails
- Clusters of patches that cover a large area
Difference between lupus and psoriasis causes
When it comes to psoriasis, the exact cause is unknown, but we do know that it tends to run in families and seems to be related to the functioning of our immune system. Sometimes, psoriasis can be triggered by a skin injury, including a cut or surgery. We also know that emotional stress, infections such as strep throat, and certain medications such as beta-blockers can trigger this skin condition.
In psoriasis, the white blood cells, known as “T cells,” attack a person’s own skin. This sets off a reaction that dilates blood vessels and seems to attract other white blood cells. What ends up happening is an increased production of skin cells that move too quickly to the surface, causing a red, scaly appearance.
Lupus is an autoimmune disease, which can be caused by a combination of genetics and environmental factors. Some individuals, it seems, have a predisposition for the development of lupus, and when they encounter something in their environment that triggers lupus, the symptoms arise, and the disease becomes active.
Potential triggers of lupus include exposure to sunlight, having an infection, or taking certain medications such as anti-seizure medications, blood pressure medications, and even antibiotics.
Comparing psoriasis and lupus: Risk factors and complications
The reality is, anyone can get psoriasis, but certain factors can increase your risk of getting this skin disease. As mentioned above, family history is a potential risk factor. Also, viral or bacterial infections can increase the chance of getting psoriasis. People with HIV, for example, are more likely to develop this skin condition than people who have a healthy immune system. Children who tend to get strep throat a lot could also be at increased risk of getting psoriasis. While we can’t say for certain why, research shows that excess weight is a risk factor. It seems that psoriasis tends to develop in skin creases and folds. Studies have also indicated that smoking increases the risk as well as severity of psoriasis.
If you have psoriasis, you should be aware of the associated complications. We have already mentioned psoriatic arthritis, which can cause joint damage and pain, but psoriasis can also lead to eye disorders. There is also evidence that people with psoriasis have a greater chance of getting type 2 diabetes. High blood pressure, Parkinson’s disease, and kidney disease have also been found in those who suffer from psoriasis.
Lupus is an autoimmune disease, so it cannot be completely prevented. Some risk factors that have been found to increase the odds of developing lupus include being a female, being between the ages of 15 to 44, being African American, Hispanic/Latino, Asian American, Native American, Native Hawaiian, or Pacific Islander, and having a family history of lupus. About five to 13 percent of individuals who develop lupus have some family history of the disease.
Because lupus can have an impact all over the body, there are numerous complications that can occur, including kidney damage, kidney failure, and complications to the brain and nervous system, resulting in headaches and memory problems, blood problems like anemia, inflammation of the lungs, inflammation of the heart, increased risk of infections, cancer, bone tissue death, and pregnancy complications like miscarriage.
Differentiating lupus and psoriasis diagnosis and treatment
A physical exam and medical history will help a doctor determine whether you have psoriasis. An examination of your skin, scalp, and nails can tell a lot. In some cases, a doctor will take a skin biopsy to help determine the exact type of psoriasis.
While there is no cure for psoriasis, treatments can lessen the severity of the symptoms and reduce the number of outbreaks a person experiences. The treatment really depends on the severity of skin condition. A doctor might suggest topical ointments, oral medications, injected medications, or perhaps, light therapy. Light therapy can slow down or even stop the growth of skin cells in the affected area.
To diagnose lupus, laboratory tests, imaging tests, and biopsies may be employed. Your doctor may request a complete blood count, erythrocyte sedimentation rate that observes how fast blood cells fall to the bottom of a tube (a fast rate indicates a systemic disease), kidney and liver assessments, urinalysis, and antinuclear antibody test.
Imaging tests include chest X-ray and an echocardiogram to check for fluid in the lung and the heart valves.
There are several treatment options for lupus, including corticosteroids, antimalarials, repository corticotropin injection (which contains the hormone adrenocorticotropic hormone), and aspirin. Other accompanying medications to treat coexisting conditions include diuretics, blood pressure medication, anti-seizure medications, antibiotics for infections, and bone-strengthening drugs to prevent osteoporosis.
Prevention tips for psoriasis and lupus flare-ups
The exact cause of lupus isn’t well understood like in many autoimmune diseases, and preventing it completely is hard. What you can do if you have lupus is manage your condition to reduce the risk of flares. This can be done by avoiding triggers like sunlight, paying attention to your diet, exercising regularly, as well as recording your symptoms and documenting the triggers.
Generally speaking, dermatologists suggest that an anti-inflammatory diet rich in leafy greens, fresh fruits, and omega 3 is good for your skin. If you have a skin condition, it is best to try slowly eliminating different foods from you diet to see if that makes a difference. People with psoriasis should avoid spicy food, alcohol, and coffee.
Here are a few natural remedies that used to help with psoriasis.
- Warm bath – this helps you relax and de-stress. It also helps remove scales and calms irritated, inflamed skin. Adding Epsom salts can be effective.
- Daily moisturizers – apply a heavy base of moisturizer following a shower or bath. In the colder months, apply moisturizer more than once a day.
- Sunlight therapy – expose skin to a little sunlight. It can improve psoriasis. Be careful not to over-expose or you can make the condition worse.
- Trigger elimination – focus on what might trigger symptoms and try eliminating them from your daily routine.
- No scratching – it can make your skin condition worse.
- Mild soaps – with either no scent or minimal perfume.
- Humidifier – it will add moisture to the air and also to your skin.
- Light, cotton clothing – it will be less irritating for your skin.
- Stress reduction – stress affects all aspects of your health.