Nail psoriasis causes changes to the fingernails and toenails, ranging from discoloration to alterations in the nail bed. There are various treatment options, such as hydrocortisone cream and corticosteroid injections.
The condition can have a physical and emotional impact on a person and affect their quality of life. It can take time for symptoms to improve, but treatment is available.
A study published in 2016 noted that 80–90% of people with psoriasis may also have nail psoriasis. It is even more prevalent in people with psoriatic arthritis.
Nail Psoriasis: Definition, Treatment, And Home Remedies
. People with psoriasis have an overactive immune system, which causes these cells to reproduce every 3–4 days. As a result, some visible skin sections are thick, inflamed, and itchy.
Nails are part of the skin. They grow from the nail root just under the cuticle, where psoriasis affects them. Nail psoriasis is a chronic condition of the immune system. It is an autoimmune condition, meaning the immune system mistakenly attacks the healthy nail tissue.
If the nail becomes detached from the nail bed, an infection can develop in the gap. When this happens, a yellowish patch may form on the tip of the nail and extend to the cuticle.
Nail Psoriasis: Symptoms, Diagnosis, & Treatment
The nail may feel uncomfortable or painful when a person applies pressure, and an affected toenail may hurt when wearing shoes. The condition can make it difficult to perform specific tasks, such as sewing.
A fungal infection affects the already formed part of the nail. Nail psoriasis causes issues in the area where the new nail is forming.
Because topical medications for psoriasis may never reach this area, doctors may prescribe oral medications instead. A doctor can prescribe medications to treat both psoriasis and a fungal infection at the same time.
Understanding Nail Psoriasis
If a person also has a fungal infection, their doctor may prescribe terbinafine (Lamisil) or itraconazole (Sporanox). However, these drugs can have adverse side effects, ranging from a skin rash to liver damage.
For example, while working with the hands, it is a good idea to wear rubber or cotton gloves. This can protect the hands from injury and the fingers from harmful bacteria. It can also help protect the nails from corrosive materials such as cleaning agents. However, a person should avoid latex gloves, which can irritate sensitive skin.
The American Academy of Dermatology Association (AAD) recommends that a person with nail psoriasis keep their toe- and fingernails trimmed and clean to prevent bacteria from building up and refrain from cleaning the nails with a sharp object. If having a manicure, a person should request the manicurist not to push back or touch the cuticles.
Nails: Infections, Anemia, Psoriasis: What Nails Can Reveal About Your Health
Rubbing moisturizers into the nail and cuticle helps to keep the nails soft. A pharmacist or healthcare professional can advise about suitable products that prevent the hands, feet, and nails from becoming too dry. A thick, fragrance-free product is best.
If the nails show symptoms of psoriasis or fungal infection, a person should contact their doctor. This is especially important for people who already have a type of psoriasis.
A person may have to try several treatments before finding one that works. Symptoms can take time to improve and may take up to a year to clear. One reason for this is that the nail plate grows very slowly. The symptoms may also return at a later date.
Nail Psoriasis: A Review Of Treatment Options
There is currently no cure for psoriasis. Anything that irritates the skin can cause the condition to flare up. The AAD offers the following advice to avoid flare-ups whenever possible:
If a person wants to hide the effects of nail psoriasis, they should talk with their dermatologist about the best options. Sometimes using nail polish or having a professional manicure might help, though a person should take care not to touch the cuticles and tell their nail technician about their condition. Certain types of nail polish and nail polish remover for people with sensitive skin do not contain the harsh chemicals that regular products do.
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. Untreated, it can also lead to joint problems.
Nail Psoriasis: Diagnosis, Assessment, Treatment Options, And Unmet Clinical Needs
There is currently no cure for nail psoriasis. However, many treatment options may make the condition more comfortable. Even if a person’s nail psoriasis is severe, there are many ways to avoid or manage flare-ups. Symptoms may take up to a year to clear.
People of Color with nail psoriasis may develop what looks like small pinpricks on the nail. The nails may also become thicker, crumble, and develop discoloration. Nail psoriasis can mimic other conditions. Often, a doctor
Nail psoriasis does not always cause physical pain but may cause embarrassment. Doctors often use a scoring system to help determine the severity of symptoms. Treatment can prevent the condition from worsening.
Psoriatic Arthritis And Nail Changes: Exploring The Relationship
Nail psoriasis can resemble a fungal infection, making diagnosis difficult. Getting a correct diagnosis is vital because the treatment for a fungal infection is different from nail psoriasis treatment. Anyone with psoriasis who experiences changes in their nails should make sure their doctor is aware of their psoriasis.
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Up to nearly 90 percent of people with PsA have nail involvement. “Both fingernails and toenails can be affected, and it can affect one nail or all 20 nails, ” says Mona Gohara, MD, associate clinical professor of dermatology at Yale School of Medicine. But considering how distorted nails can become when you have psoriatic arthritis, even one affected nail can be one too many.
How To Care For Your Nails At Home With Psoriasis Or Psoriatic Arthritis
These depressions on the nail are the most common symptom of PsA, occurring in more than two-thirds of people with the disease, according to the Psoriasis and Psoriatic Arthritis Alliance. They can be small and shallow or big and deep.
This is the gradual (and, thankfully, painless) separation of a nail from the underlying nail bed. The pocket created can form a pathway for bacteria or fungi to infect the nail bed. About one-third of people with nail psoriasis develop a fungal infection.
The buildup of skin cells creates a flaky or chalky substance (doctors often refer to it as debris) that accumulates under the nail. It’s more of an issue in toenails because the constant pressure from wearing shoes can become uncomfortable.
Figure 2 From Psoriatic Arthritis And Nail Changes: Exploring The Relationship.
Inflammation of the matrix, the area at the base of the nail where the cells that produce new nail growth are produced, can cause these grooves and ridges that run lengthwise and are known as Beau’s lines. They usually occur on every fingernail or toenail.
Skin and nails are made of the same protein, so the rapid, excess growth of skin cells can also cause nails to grow too quickly and/or too thickly.
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.
How Does Psoriatic Arthritis Affect Nails?
The good news is that there are many treatments for nail psoriasis: The two mainstays are topical steroids and the vitamin D-based treatment calcipotriene. Treatments like biologics and retinoids — which work throughout the body — can also treat both your skin and nails.
The bad news is that treating nail psoriasis can be tough as, well, nails. The condition can be stubborn, so you may need to use more than one treatment. Nails also grow slowly, so even if a treatment works, it can take a while — up to a full year for fingernails, and two years for toenails, to grow out — before you’ll see the full benefit. That can be a long time to wait when your nails look distorted.
Damage or injury to the nails can cause or worsen nail psoriasis. Any sort of physical trauma can lead to what’s called the Koebner phenomenon. This is when you get a flare where the skin or nail has been injured. Keeping nails short can minimize trauma from everyday tasks. It can also help prevent nails from lifting off of fingers and toes and discourage buildup under the nails.
Nail Psoriasis: The Journey So Far Dogra A, Arora Ak
This includes housework, yard work, and home repairs. Any time you irritate your skin or nails, psoriasis can flare. When doing wet work like washing dishes, it’s best to wear a cotton glove and then place a vinyl or nitrile (synthetic rubber) glove over it. According
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