Psoriasis affects around 7.5 million Americans, according to the American Academy of Dermatology, but it is often confused with a fungal infection. Psoriasis and fungal infections often share similar symptoms, like redness and itching, making them difficult to tell apart.[1]
This article provides tips to help differentiate between psoriasis and fungal infections, along with information on risk factors, causes, and signs that warrant a visit to your doctor.
Is It Psoriasis or a Fungal Infection?
If you’re seeing red, itchy patches on your skin, determining whether it’s psoriasis or a fungal infection isn’t always straightforward. Look closely at the red patches: if they appear silvery, it’s likely psoriasis; if they resemble circles or rings, it’s more probable to be a fungal infection.[2]
What is Psoriasis?
Psoriasis is an autoimmune disorder causing an accelerated life cycle of the skin. It results in the formation of itchy and scaly patches in parts of the body mostly affected—knees, elbows, trunk, and the scalp.
Normal skin cells develop and shed within a period of about four weeks.[3] In psoriasis, the skin cells are produced more rapidly than usual, and therefore do not have time to shed off normally, causing discomfort.
Is Psoriasis a Fungus?
Psoriasis is not caused by a fungus. It’s an autoimmune condition where the immune system triggers rapid skin cell growth, resulting in thick, red patches with silvery scales.
What is a Fungal Infection?
Ringworm. Getty Images/phanasitti
Fungal infection, also known as mycosis or fungal disease, is a type of disease caused by numerous kinds of fungi, yeasts, and molds.
Fungi mostly infect the skin or the nails, but other possible areas include parts of the mouth, lungs, and throat, even reaching the urinary tract.[4]
Common fungal infections include athlete’s foot, ringworm, nail fungus (onychomycosis), and oral thrush (candidiasis).
Signs and Symptoms of Psoriasis
Plaque: Raised, reddish skin patches
Silvery Scales: Thick, dry patches often have a white covering of scales.
Itchy, Cracked Skin: It may itch and crack, sometimes leading to bleeding.
Nail changes: Pitting, discoloration, or thickening of nails.[5]
Inflammation: Redness and swelling in affected areas
Koebner Phenomenon: New patches may develop at sites of skin trauma or injury
Signs and Symptoms of Fungal Infections
Redness
Itching and stinging in the affected area
Circular or ring-like rash
The skin may develop scales or flakiness.
Discoloration and blisters on the affected area[6]
Cracking or peeling of the skin
Small bumps, patches, or raised areas
Unpleasant odor
Nail Involvement
Psoriasis Risk Factors
While doctors haven’t pinpointed the exact cause of psoriasis, genetics are known to be a factor.
Other risk factors or factors that can aggravate psoriasis include:
Obesity
Smoking
Cold or dry air
Various environmental factors
Chronic or severe stress
Difference Between Psoriasis and Fungal Infection – An Overview
Aspect
Psoriasis
Fungal Infection
Cause
Chronic autoimmune condition
Caused by various types of fungi
Genetic Predisposition
Common, tends to run in families
Not typically associated with genetics
Triggers
Stress, infections, injury to the skin, certain medications
Often related to warm, moist environments, contact with fungi
Locations
Scalp, elbows, knees, lower back, nails, can appear anywhere
Warm, moist areas like feet, groin, scalp, nails
Contagious
Not contagious
Contagious, can spread from person to person or via surfaces
Symptoms
Red, raised patches with silvery scales, may itch.
Redness, itching, scaling, sometimes blisters or oozing, may have characteristic appearances (e.g., ringworm)
Antifungal medications (topical creams, oral medications, shampoos, nail lacquers)
What are the Causes of Psoriasis and Fungal Infections?
Knowing about psoriasis and fungal infections isn’t sufficient without understanding their causes. Let’s examine the causes of each condition separately.
Causes of Fungal Infections
Various fungi cause fungal infections, each leading to specific types of infections.
Dermatophytes, responsible for ringworm and athlete’s foot, infect the skin’s keratin layer.
Yeast infections, like those caused by Candida species, occur due to skin barrier disruption or environmental changes.
Different types of fungi can cause these fungal infections, and they’re often superficial, affecting the hair, skin, nails, or any area in contact with the fungus.
Fungal infections spread easily through contact, such as:
Direct contact with infected individuals
Contact with animals carrying fungal infections
Interaction with unwashed items like toys, floors, or clothes
Exposure to contaminated surfaces like public pools or bathrooms
Causes of Psoriasis
The cause of psoriasis isn’t entirely clear but likely involves genetics, environment, and immune system factors.
Genetics: Family history and genetic variations increase the risk. Specific genes, like HLA-Cw6, increase susceptibility.[7]
Immune system dysfunction: Autoimmune response attacks healthy skin cells. T cells release cytokines, causing inflammation.
Environmental triggers: Stress, infections, skin injury, smoking, and certain medications.
Your dermatologist or doctor will base the diagnosis on what is seen but may need tests to be done in order to confirm the cause of the nail problem.
Nail Psoriasis VS Fungus
Nail Psoriasis
Testing the nail through a biopsy or analyzing nail clippings can help confirm psoriasis.[8]
Your healthcare provider will also check for plaques or lesions on other parts of your body.
Sometimes, dermoscopy, a close dermatoscopic examination, may be used.
Nail Fungus
Scraping or clipping is taken for testing either to confirm nail fungus or to identify the organism causing the infection.
Lab tests of skin or nail particles can pinpoint the exact fungi causing the issue and guide treatment.
Psoriasis Treatments
The goal of treating psoriasis is to lessen inflammation, slow down skin cell growth, and ease symptoms. While there’s no cure yet, various treatments can help manage the condition.
Fungal infections often respond well to topical antifungal creams or oral tablets, some available over the counter.[11] If these infections persist, your doctor might recommend changes in hygiene habits.
Treatment focuses on eliminating the underlying fungus through:
Hygiene Adjustments
Topical and Oral Antifungals
Nail removal, if necessary
Antifungal Shampoos
When to See a Doctor
If your itching persists without diagnosis or worsens, it’s best to contact a doctor. Also, seek a stronger prescription if an over-the-counter treatment isn’t effective.
Since these conditions appear similar, your doctor may need more than a visual inspection to determine the cause. In such cases, a biopsy may be necessary to identify the underlying issue and facilitate appropriate treatment.
Summary
Differentiating between psoriasis and fungal infections can be difficult because their symptoms overlap. If you’re experiencing red, inflamed, and itchy skin and are unsure if it’s psoriasis or a fungal infection, seeking a professional opinion is crucial.
If you’re unsure whether you have psoriasis or a fungal infection, you can reach out to UVB Treat by filling out a simple form. Our professionals will assist you with your condition and recommend a personalized solution.
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American Academy of Dermatology Association. “Skin Conditions by the Numbers.” Aad.org, 2019, www.aad.org/media/stats-numbers.
Unlike psoriasis, nail fungus doesn't cause pits in the nails. Instead, nails may change shape, becoming thin, thickened, or developing patches over time.
Psoriasis and fungal infections can resemble each other, but they can also coexist. An accurate diagnosis is crucial to determine if you're dealing with one or both conditions.
Psoriasis often affects fingers, while fungal infections typically target toenails, starting with one toe. If only one toenail is affected, it's likely a fungal infection or trauma-related, not psoriasis.
