If you have psoriasis, it's important to check your fingernails and toenails for signs of nail psoriasis. Common signs include: Tiny dents in your nails (called “nail pits”) White, yellow, or brown discoloration.
Psoriatic arthritis can also cause different color changes in your nails, like: Oil drops or salmon patches are small, yellow-pink patches on the nail bed. These are usually only seen in psoriasis or psoriatic arthritis. Leukonychia are small, white dots or lines on the nails.
Pits, horizontal lines, deformity, discoloration, onycholysis (lifting of the nail plate from the nail bed), brittle nails that crumble or splinter, and thickening of the nails can all be signs that nail psoriasis is present.
Psoriasis is a multifactorial systemic disease including inflammation and epidermal hyperproliferation. Nail psoriasis can involve the nail bed, nail matrix, hyponychium, and nail folds.
The two can be differentiated by the appearance, as psoriasis has a classical yellow nail pitting (indentation) which is not found in any fungal infection. The yellow pitting in psoriasis and hyperpigmentation (dark discoloration) in the case of fungus can be the strong differentiating points.
Unlike a fungal infection, nail psoriasis does not spread through contact. Without treatment, nail psoriasis may get worse. In severe cases, it may become difficult for a person to use their hands or feet because of the discomfort of nail damage.
The common clinical manifestations of nail psoriasis are nail Pitting, subungual hyperkeratosis, onycholysis, and oil drop discoloration. However, nail plate crumbling, red spots in lunula, leuconychia, and splinter hemorrhages are other features.
There isn't a cure for nail psoriasis. It's a long-lasting (chronic) condition, which means flare-ups can occur throughout your life. You may have flare-ups and times when the symptoms go away (remission). Treatments can provide relief for your symptoms.
Keep nails as short as possible. Loose nails can continue to be injured if they rub against surfaces. It is important to protect your nails from damage because trauma will often trigger or worsen nail psoriasis. One easy way to do this is to wear gloves while working with your hands.
Nail psoriasis is a common condition seen in about 10-78% of patients with psoriasis vulgaris and 70-80% of patients with psoriatic arthritis. 5-10% cases have isolated nail involvement.
In the absence of a definitive diagnostic test for psoriatic arthritis (PsA), your health care provider will diagnose you by examining your skin, nails, joints and other symptoms. You may have X-rays, an MRI, an ultrasound and blood tests as well.
Psoriatic arthritis causes inflamed, swollen, and painful joints. It happens most often in the fingers and toes. It can lead to deformed joints.
PsA is often undiagnosed and can be misdiagnosed for rheumatoid arthritis (RA) or osteoarthritis (OA), especially in a non-rheumatologic setting [7–9]. RA is a chronic inflammatory arthritis typified by pain, swelling, and stiffness of the joints, particularly symmetric small-joint synovitis of the hands and feet [10].
Color changes
White, yellow, or brown discoloration and/or reddish marks (aka splinter hemorrhages, which are caused by tiny burst blood vessels under the nails) are common among people with psoriatic arthritis.
At a basic level, psoriasis is a disorder of the immune system. White blood cells called T-helper lymphocytes become overactive, producing excess amounts of cytokines, such as tumor necrosis factor, interleukin-2, and interferon-gamma. In turn, these chemicals trigger inflammation in the skin and other organs.
Conventional systemic treatments, including methotrexate, cyclosporine, acitretin, and apremilast, as well as intralesional corticosteroids, can also be effective treatments for nail psoriasis.
Autoimmune diseases can affect your nails in various ways. If you have alopecia or Hashimoto's disease, your nails can become shaped like a spoon in a concave position. Alopecia can also cause your nails to become weak and crumbly. With Hashiomoto's, your nails may start splitting easily.
Rashes or patches of red, inflamed skin, often covered with loose, silver-colored scales; in severe cases, the plaques will grow and merge into one another, covering large areas. Itchy, painful skin that can crack or bleed. Small areas of bleeding where the involved skin is scratched.