Nail Psoriasis Pictures and Treatments
Up to 7.5 million people have the autoimmune disease known as psoriasis. In people who have this condition, the body produces too many skin cells. Those extra cells build up on the skin, forming scaly red or silvery white patches, sores, or blisters. Psoriasis can occur anywhere on the body, including the chest, arms, legs, trunk, and the nails.
About half of people with psoriasis, and around 80 percent of people with psoriatic arthritis, the related joint condition, develop nail changes, according to the National Psoriasis Foundation. Doctors aren’t sure why some patients’ nails are affected while others’ nails are not. In rare cases, the nails are the only part of the body that shows signs of psoriasis. Usually, however, people with psoriasis have it on other parts of the body as well.
The nail plate is the hard surface that forms the base of the nails. In people with nail psoriasis, the nail plate can lose cells. This causes small pits to form on the fingernails or toenails. How many pits there are varies from person to person. Some people may have only a single pit on each nail, while others have dozens of pits. The pits can be shallow or deep.
Nail Bed Separation
Sometimes the nail can separate from the nail bed, which is the skin underneath the hard nail plate. This separation is called oncholysis. It leaves an empty space under the nail. If you have nail psoriasis, you may first notice a white or yellow patch at the tip of the nail. The color will eventually go all the way down to the cuticle. Bacteria can get into the space under the nail and cause infection, which can turn the whole nail a dark color.
Changes in Nail Shape or Thickness
In addition to pitting, you might notice one or more other changes in the texture of your nails. Psoriasis can cause lines called “Beau lines” to form across the nails. Weakness of the structures that support the nail can cause the nails to crumble. Nails can also become thicker due to a fungal infection called onychomycosis, which is common in people with psoriasis.
The color of all—or part—of your nail may also change. You might see a yellow-red patch in the nail bed. It looks like a drop of oil under the nail plate, which is where it gets its name: “oil drop spot.” The toenails—and sometimes the fingernails—can also turn a yellow-brown color. Crumbling nails often turn white.
Treatments for Nail Psoriasis
Because psoriasis affects the nail as it grows, nail psoriasis can be hard to treat. Your doctor may prescribe a steroid that you rub onto your nail, or that is injected into the affected nails. If you have a fungal infection, your doctor will treat it with antifungal drugs you take by mouth. Cosmetic treatments such as nail filing, polish, and artificial nails can improve the appearance of your nails while they heal. Some people will need to have the diseased nails removed.
Caring For Your Nails
While you take medicine to treat your nail psoriasis, take special care to protect your nails at home. If your nails are loose and beginning to separate from the nail bed, keep them trimmed very short so they won’t catch on anything and rip off. Wear cotton gloves whenever you are gardening or working with your hands. Gloves can help keep your nails from becoming injured.
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- Hands, Feet and Nails. (n.d.). National Psoriasis Foundation. Retrieved September 13, 2013, from http://www.psoriasis.org/about-psoriasis/specific-locations/hands-feet-nails
- Nail Psoriasis. (n.d.) The Psoriasis and Psoriatic Arthritis Alliance. Retrieved September 13, 2013, from http://www.papaa.org/further-information/nail-psoriasis
- Treatment of Psoriasis. (2013, August 27). UpToDate. Retrieved September 13, 2013, from http://www.uptodate.com/contents/treatment-of-psoriasis