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Patient Insights: Severe psoriasis & eczema 

Howard Chang has lived with psoriasis and atopic dermatitis for 40 years. Now a prolific blogger, he hopes to help others feel less alone

Howard Chang has lived with severe psoriasis and atopic dermatitis for almost 40 years since childhood. Now a prolific blogger, he hopes to help other people feel less alone and build more awareness of these challenging conditions.

How were you diagnosed with severe psoriasis and eczema?

My psoriasis diagnosis came in childhood when I was about eight years old. Psoriatic lesions broke out on my skin after sleeping in an unwashed, new sleeping bag. The dermatologist at the local clinic said it was psoriasis and started me on topical coal tar and steroid therapies. I added ultraviolet light B (UVB) a year later. The diagnosis was confirmed by the University of California, San Francisco dermatologists when I turned ten years old.

I don’t remember when the doctors diagnosed the eczema. When I think back on hot summer days in elementary school I remember having itchy eczema rashes on my neck and skin folds. As a child I felt confused as to what was eczema and what was psoriasis. In the past decade, however, I’ve learned more about eczema, and how to differentiate the two. Unfortunately, eczema has become just as difficult to treat as psoriasis, and treating both of them at the same time adds another level of complexity as some treatments for one can flare the other.

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