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What Is Nail Psoriasis?

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  • Written By: Henry Gaudet
  • Edited By: A. Joseph
  • Last Modified Date: 17 October 2014
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Although psoriasis primarily is a skin condition, it also can affect fingernails and toenails as well. Nail psoriasis, or psoriatic nail disease, causes discolorations, deformations and other abnormalities in the nail and nail bed. In most cases, skin psoriasis, or cutaneous psoriasis, is present when nail psoriasis develops. Psoriatic arthritis often is accompanied by psoriatic nail disease as well.

The causes of nail psoriasis are not fully understood, but heredity does play a role. Environmental and immunologic factors also contribute to an individual’s likelihood of developing the condition. Psoriatic nail disease is not contagious, however, so it cannot be passed on through contact.

Nail psoriasis can be identified by a number of commonly observed markings and discolorations of the nail. Horizontal lines called "Beau’s lines" might be visible running side to side across the nail, or white spots called "leukonychia" might be visible. Discoloration of the nail is common, and oil spots or salmon patches, which appear to be drops of oil or blood trapped under the nail, also might be present. A splinter hemorrhage, where a tiny break in the skin cause a small bleed under the nail, might be visible as a thin black line running the length of the nail. Spotted lunula, a congestion of the capillaries under the nail, might appear as a reddening of the arch at the base of the nail.

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Changes in the nail’s shape and structure also are common. Nail psoriasis commonly causes pitting. The skin under the nail might thicken and cause the nail to loosen and separate. When psoriasis affects the nail bed, crumbling of the nail might result. Exposed nail beds are more vulnerable to infection, further complicating the condition.

Approximately 5 percent of people with psoriatic nail disease have no visible signs of skin psoriasis. In these cases, a biopsy might be required to confirm the diagnosis. There is no cure for nail psoriasis. Medical treatment is focused on minimizing symptoms, improving the appearance and function of the nails and treating any complicating issues such as infection.

A doctor might prescribe topical creams and ointments to treat nail psoriasis. In some cases, the doctor might determine that the nail or a portion of the nail must be removed. This can be done with chemical treatment or through surgery.

Trimming back nails will reduce the chance of infection by helping to prevent them from catching and pulling away from the nail bed. Care for affected nails must be done gently. Overly aggressive grooming or nail care might cause the psoriasis to flare up and worsen the condition.

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serenesurface
Post 3

Light therapy or sunlight therapy is effective for both skin psoriasis and nail psoriasis. I developed skin and nail psoriasis last year. My doctor recommended getting more sunlight. So I started exposing my skin and hands to sunlight daily. I started with ten minutes and slowly increased the amount over the course of several months. The nail psoriasis disappeared completely and my skin psoriasis is much better.

SarahGen
Post 2

@ZipLine-- Psoriasis itself is not an infection. But the changes and deformities that it causes in the nails can lead to infections. For example, severe nail psoriasis may cause the nail to split from the skin. When this happens, bacteria can get underneath the nail and lead to an infection without the person even realizing in the beginning.

So nail psoriasis needs to be taken serious and treated quickly to prevent these complications. Ointments may help but sometimes they're not enough.

ZipLine
Post 1

Psoriasis is not an infection, so cutting or removing nails doesn't sound like the best idea to me. Psoriasis is a genetic condition and is also related to the immune system. So when the nail grows back out, the psoriasis symptoms will probably return. Of course if the nail is so deformed due to psoriasis that it's causing pain or other problems for the patient, then the doctor may want to remove a part of it. Otherwise, it's probably a good idea to stick to creams and ointments to treat nail psoriasis. I'm not a doctor but I've had nail psoriasis for ten years. So I'm just speaking from experience.

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