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What is this problem. It's appares on the knee.

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American Academy of Dermatology dry scaly itchy patches eczema psoriasis symptoms

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eczema AND psoriasis

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The photo looks most consistent with a dry, thickened, darker patch of chronic dermatitis (eczema) or friction-related skin thickening. Repeated rubbing/scratching and dry skin can make skin on the knee become rough, scaly, and darker.
Other possibilities include:
  • Psoriasis, especially if it becomes a sharply outlined red plaque with thick silvery scale, often also on elbows, scalp, or elsewhere.
  • Fungal infection (ringworm) if it develops a raised, scaly ring-shaped edge with clearer skin in the center.
A photo cannot confirm the diagnosis. Nummular eczema and psoriasis can look similar and sometimes require an in-person skin examination or testing to rule out fungus. The Textbook of Family Medicine describes eczema as dry, itchy/scaly lesions and notes that fungal infection and psoriasis may need to be distinguished clinically, Textbook of Family Medicine, p. 934. The AAD comparison notes that psoriasis commonly affects knees and causes thicker, well-defined scaly patches.
What you can do now
  • Apply a plain thick moisturizer, such as petroleum jelly or a fragrance-free cream, 2-4 times a day and after bathing.
  • Avoid scrubbing, harsh soaps, hot water, and rubbing/kneeling on it.
  • If it is itchy or inflamed, a pharmacist or clinician may advise a short course of a mild steroid cream. Do not use a steroid alone if you suspect ringworm, because it can mask and worsen a fungal rash.
  • Arrange a dermatology or primary-care review if it persists beyond 2-3 weeks, spreads, repeatedly returns, or is very itchy.
Seek prompt medical care if it becomes painful, warm, rapidly red/swollen, drains pus, forms open sores, or you develop fever.
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