Nail Psoriasis

Psoriasis is basically a condition related to the skin. However, this condition can affect ones toenails as well as fingernails. Psoriasis results in a variety of symptoms including discoloration of the affected nails, pitting on the nail surface and anomalous nail growth. Nails affected by psoriasis may eventually loosen and detach from the nail bed that supports the nails. This is called onycholysis. In case of severe nail psoriasis, the nails may even start crumbling.

Nail psoriasis is also known as psoriatic nail disease and it leads to deformations, discoloration and various other irregularities of the skin as well as the nail bed. In majority of such incidents, a person already suffers from skin psoriasis (also called cutaneous psoriasis) when they develop nail psoriasis. In addition, nail psoriasis is often accompanied by psoriatic arthritis.

Scientists are yet to comprehend the precise reasons that lead to the development of nail psoriasis. However, one thing is certain - hereditary plays some role in this disease. In addition, immunologic as well as environmental factors are also said to contribute to this skin condition.

Nail psoriasis is, however, not a contagious condition and, hence, it does not spread when people come in contact with an affected individual. It is, nevertheless, strange that often several members of the same family are found to be suffering from psoriasis. What is certain is that psoriasis is not an allergic reaction. It is not caused due to any infection.

So far as what health practitioners have determined nail psoriasis is not caused due to any deficiency of vitamin or mineral in the patient's body. There are several common perceptible markings that helps to identify nail psoriasis. One such observation is nail discoloration.

In some cases, you may see white spots on nails affected by psoriasis. This condition is known as leukonychia. In addition, there may be visible lines running across the affected nails. Such fine lines are known as Beau's lines. In most cases, the nails are discoloured due to nail psoriasis. Other common symptoms of this disease include salmon patches and oil spots. These visible symptoms have a resemblance to oil drops or blood locked in beneath the affected nails. You may also find a splinter hemorrhage - a tiny break in the skin under the nail causing some bleeding. This wound may be seen running along the nail's length. You may also see spotted lunula, which is actually an overcrowding of the blood capillaries beneath the nail affected by psoriasis. The spotted lunula may resemble a reddish arch at the nail's base.

The alterations in the shape as well as structure of the nail are also very common when nail psoriasis develops. Generally, nail psoriasis also causes pitting on the surface of the affected nail, while the skin beneath the nail may become thicker and result in the nail loosening up and eventually detaching from the nail bed. As psoriasis spreads to the nail bed, it may result in the disintegration of the nail. When the nail bed is exposed it becomes further vulnerable to various infections, thereby complicating the condition further.

It has been found that just about 5 per cent of patients suffering from psoriatic nail condition actually do not have any observable signs related to cutaneous psoriasis or commonly skin psoriasis. In such instances, the patient might need to undergo a biopsy to confirm that he/ she is suffering from skin psoriasis. As of now, nail psoriasis cannot be cured. All the medical treatments actually focus on diminishing the symptoms related to the condition, enhancing the appearance as well as the functioning of the nails. In addition, the treatments involved in this case also try to cure other complex issues like infection of the nail bed and surround areas.

Doctors may prescribe creams and ointments for external application to people suffering from nail psoriasis. In a number of instances the physician may decide to remove a portion or the complete nail affected by psoriasis. There are two ways to remove the affected nail - either through chemical treatment or via surgery.

Cutting the nails short will also prove to be helpful. It reduces the risks of developing infections by preventing them from catching the nails and pulling them apart from the nail bed. What is most important is that the patients should take care of the affected nails regularly and very gently. Grooming the nails in a very aggressive manner or belligerent nail care may result in flare up of psoriasis and eventually make the condition worse.

Symptoms of nail psoriasis

Nail psoriasis is a skin ailment that may cause a variety of diverse symptoms, including pitting, nail bed separation, and changes in the thickness or shape of the affected nails as well as discoloration of the nails. These symptoms are discussed in brief below.

Pitting

The surface of the nails is composed of keratin cells, which makes its top hard as well as thick. When the nails are affected by psoriasis, it results in loss of the keratin cells. As a result, there are formation of small pits on the surface of the toenails and fingernails. However, there is no fixed number of pits that form on the nail plate and it generally differs from one person to another. While there may be just a solitary pit on each nail surface in some cases, others affected by the condition may have several such pits on each nail. In addition, the pits on the surface of the nails may be deep or shallow.

Nail bed separation

Occasionally, nail psoriasis may cause the nail to separate from the nail bed or the skin beneath the nail plate. Such type of nail separation is known as oncholysis. When this occurs, it leaves a vacant area under the hard nail. If you are suffering from nail psoriasis, it is likely that you will first detect a yellow or whitish patch developing beneath the nail due to infection in the area. In due course, the color of the patch as well as the whole nail will turn dark.

Changes in nail shape or thickness

Aside from formation of pits on the nail surface, you may also see a number of other changes in the nail's texture. In fact, nail psoriasis may also result in formation of lines known as Beau's line across the affected nails. The condition causes the structures on which support the nails to become weak and this may cause the nails to crumble. In addition to these changes, the nails also turn out to be thicker owing to the fungal infection. This condition is known as onychomycosis, which is frequent in people suffering from psoriasis.

Discoloured nails

When psoriasis affects the nails, it may often result in its discoloration. Many people enduring this condition may see a yellowish-red area in their nail bed. This discoloured patch in the nail bed has resemblance to oil drop under the nail plate. The term oil-drop spot derives its name from this symptom. At the same time, the color of the fingernails and toenails of the person suffering from nail psoriasis my also change to yellowish-brown. When the nails begin to crumble, their color changes to white.

Treatment options

Often treating nail psoriasis may be difficult. This is because psoriasis keeps affecting the nails as they continue to grow. There are, however, various options to treat this condition. Some of these options comprise a prescription steroid, which can be rubbed onto the affected nail. Alternately, your physician may inject steroid into the nail bed affected by psoriasis. You can also use anti-fungal drugs orally with a view to heal the infections. Another method to cure this condition is employing nail psoriasis therapy. The last treatment method entails exposing the areas affected by psoriasis to ultra-violet (UV) rays.

While the therapeutic process is on, you may simultaneously use cosmetic treatments like nail polish and nail filing, which may enhance the nail's appearance while they are healing.

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