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How To Tell The Difference Between Nail Fungus And Psoriasis

Psoriasis Or Nail Fungal Infection How To Tell

Difference between Fungal Infection and Psoriasis

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Although it is a relatively common disease, when it comes to nail fungal infections, theres a possibility of getting a false diagnosis, one that confuses onychomycosis with nail psoriasis, two completely different pathologies.

Therefore, performing a laboratory test is essential to determine if theres a microorganism causing an infection or not.

How can you differentiate them at plain sight? Keep reading!

Nail Psoriasis Or Fungus How To Know When To See A Doctor

Imagine a great mani-pedi session leaving your hands and feet feeling soft and clean. Sounds great right? But wait? Are you seeing some unusual changes on your nails? Discoloration? An unseen spot? Cracking? Your nails might be trying to tell something.

Our nails are made up of keratin-the same protein that makes up your skin and hair. There are times when the keratin structure is altered, damaged, or taken over by fungal infections.

It is not uncommon to have trouble with your nails. However, sometimes it can get complex if not treated timely. You may be suffering from nail fungus or nail psoriasis.

Nail fungus or Onychomycosis is an infection caused by fungus growing in your nails. It is a contagious disease that begins as a white or yellow spot on your nails. The fungus can spread rapidly infecting your entire nail. It may even turn brown or black if left untreated.

Psoriasis is a chronic autoimmune skin disease. People suffering from this disease have red, scaly patches on their skin. Psoriasis is a genetic autoimmune disease that spreads to your chest, trunk, fingernails, and toenails. Fingernail and toenail psoriasis is caused due to psoriasis.

Toenails and fingernails are susceptible to both of these nail infections. If you notice any of the below-mentioned symptoms, you must seek help from your dermatologist immediately.

Is It Toenail Fungus Or Something Else

Odd-looking toenail? It may be a fungal infection, but there’s a good chance that another condition could be to blame.

If you notice an odd spot on your toenail, you might assume its a fungal infection. However, theres a good chance that its not.

Spots or discolorations on or under a toenail could be bruises resulting from trauma to the nail, blood blisters, warts, or even subungual melanoma, a type of skin cancer, says Ami Sheth, a doctor of podiatric medicine in Los Gatos, California, and a spokesperson for the American Podiatric Medical Association.

Since nail irregularities can be caused by diseases besides these as well, its best to get it looked at, says Dr. Sheth.

Richard Goad, a doctor of podiatric medicine at Baylor Scott & White Health in Waco, Texas, concurs. Sometimes the nail will be the first place to show another underlying problem, Dr. Goad says.

So is it a fungus, a false alarm, or another condition entirely?

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When To Talk With Your Doctor

Most people dont have perfectly matched nails, but if one or multiple of your nails looks dramatically different from the others, you should seek medical attention. I always recommend that if one nail doesnt look quite right and you arent sure why, it makes sense to bring it to your doctors attention as soon as possible, Dr. Joshi says. When it comes to nail health, the most transient thing that happens to patients is trauma. Perhaps you closed your finger in a car door or something along those lines. However, when something starts to change and you cant pinpoint exactly why, it is likely a good indication to seek medical attention, she says. For the most accurate diagnosis, consider seeing a board-certified dermatologist. Together, you can get to the bottom of your nail issues and come up with a plan of action.

Symptoms Of Nail Psoriasis

Nail Psoriasis vs. Fungus: Learn the Signs

In virtually every case of nail psoriasis, someone will show other signs of psoriasis somewhere else on their body because its a full-body inflammatory disease. About 5% of people have nail psoriasis alone, meaning they dont have psoriatic arthritis or skin psoriasis, says dermatologist Jonathan Braue, MD. If you see somebody with pretty typical plaque psoriasis, or they have a history of plaque psoriasis, and most of the nail changes theyre having are on the fingernails, then its a slam dunk.

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How To Treat Nail Fungus

There are many topical antifungal creams, liquids, and ointments available in the market. In severe cases, your doctor may prescribe antifungal pills such as fluconazole, griseofulvin, terbinafine, itraconazole, etc. Sometimes, a doctor may suggest the removal of the infected nail to avoid the spread of the fungus.

Treatment Options For Nail Psoriasis

When it comes to treatment options for both of these conditions, nail psoriasis is the hardest of the two to treat. If topical medications dont do the trick, then you should try:

  • Corticosteroid. These are steroids that are injected directly into the nail bed.
  • Biologics. Biologic drugs are medications made from living organisms and have proteins that target specific cells inside your body. These medications will assist your immune system by interfering in the inflammatory process.

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Nail Psoriasis Vs Fungus

Its not unusual to have problems with your nails. Most of the time, you can fix the issue by filing away a rough edge or clipping a hangnail. But sometimes its more complicated than that.

If your fingernails or toenails are discolored, cracking, or separating from the nail bed, you may have nail psoriasis or nail fungus.

Psoriasis is an autoimmune disease. Its symptoms can look different depending on skin tone:

  • On light skin tones, psoriasis can appear red with scaly patches on the skin.
  • On medium skin tones, psoriasis can appear salmon-colored with silvery white scales.
  • On dark skin tones, psoriasis lesions can appear violet with gray scales.

Nails and skin are closely related. If you have psoriasis of the skin, you may also develop psoriasis of the nails.

Nail fungus, or onychomycosis, is an infection caused by fungi.

Although these conditions may look the same, there are a variety of differences between them.

The symptoms of nail psoriasis and nail fungus are quite similar, and it may be difficult to tell them apart. Its important to know which you have so you can treat it properly.

Heres a comparison of the symptoms of each condition:

Symptoms of nail psoriasis
nails detach from the nail bed , creating gaps that can become infected by bacteria progressive distortion in nail shape
chalky buildup under the nail that causes the nail to lift nails may be brittle and appear dull
tenderness or pain if theres buildup under the nails foul odor

Some Of The Other Risk Factors Associated With Nail Fungus Include:

Eczema vs. Psoriasis- What Your Skin May Be Telling You About Your Health
  • Excessive sweating
  • Being an older male
  • Working in an environment where your hands and feet get wet often
  • Walking barefoot in public gyms, showers, swimming pools, and other wet, fungi-prone areas
  • Wearing socks and shoes without ventilating your feet
  • Having an illness that suppresses your immune system, such as HIV
  • Is nail fungus contagious? Living with someone else who has nail fungus can spread to you.
  • Having a nail bed injury

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Treatments For Nail Psoriasis

The same treatments you get for skin psoriasis can also treat your nail psoriasis. Because your nails grow slowly, it can take time before you see any improvements in the newly grown parts of your nail.

The treatments for nail psoriasis include:

  • Ultraviolet light is used to treat skin psoriasis and may also be useful in nail psoriasis. The treatments usually take place in a doctor’s office or a clinic.
  • Medicines that work throughout your body. Your doctor may call these “systemic medications.” Some examples are:
  • Drugs that target specific parts of your immune system. You may hear your doctor call these “biologics.” They are given by injection under the skin or through an IV. Some examples are:
  • TNF-alpha inhibitors include
  • Let’s Take A Look At Risk Factors

    As discussed earlier, having psoriasis can put you at risk for nail fungal infections. While the only risk for getting nail psoriasis is having psoriasis on your hands and feet, there are quite a few risk factors for nail fungus.2,4

    • Age: You are more likely to get nail fungus infections as you get older. This can because your nails grow slower, your circulation is not as good, and because you have been exposed to more fungi than when you were younger.
    • Having other health issues: Patients with cancer, diabetes, poor circulation, and poor immune systems are more likely to have nail fungal infections.
    • Exposure to damp environments: Fungus thrives in damp environments. If you notice that your socks are damp every time you take them off, you have to wear gloves a lot for your job, or you often walk barefoot in places like locker rooms, or pools, you are at higher risk for nail fungal infections.
    • Wearing artificial nails: Make sure that your salon uses new or freshly sterilized instruments every time you get your nails done. Additionally, acrylic nails can separate from the natural nail, leaving a place for fungus to grow.

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    Treatment Options And Lifestyle Changes

    There are several things you can do that can provide relief from skin and nail psoriasis and psoriatic arthritis .

    Once nail psoriasis is suspected, the sooner you start treatment, the better. Coordination of care between a dermatologist and a rheumatologist can provide a patient with the best course of treatment.

    Siegel says several systemic and biologic treatments that work for psoriasis and PsA can also work for nail psoriasis. Talk to your health care team to find out if this approach might be effective for you.

    Topical corticosteroids can be applied to the nail matrix with the goal of absorbing into the still-forming nail. Patients also have the option of having corticosteroids injected into the affected nail. However, the pain of the procedure can be a deterrent to this treatment.

    Using nail polish and nail polish remover with harsh chemicals such as parabens, formaldehyde and acetone can dry out the nails and cause further brittleness and possibly pain.

    Siegel and Prussick agree that being overweight can contribute to a person with psoriasis developing PsA. When belly fat increases, the amount of harmful inflammatory cytokines in the body also increases. In addition, there is some speculation that repeated stress on the joints can add to the development of PsA.

    Going for a 30-minute walk every day, staying away from high glycemic foods and managing stress can help keep psoriasis and PsA symptoms from worsening.

    How Is Each Treated

    Nail psoriasis or fungus?: Differences, symptoms, and outlook

    Eczema treatment depends on how severe it is. For mild to moderate cases, youâll use a topical corticosteroid to control inflammation, and youâll use an emollient on your skin. This type of moisturizer has an oil or cream base, not a water base, like lotion, which could dry your skin out more.

    If you have moderate to severe eczema, you may need to try a medicine that affects your immune system like , methotrexate, azathioprine, or cyclosporine. If nothing else works, your doctor may prescribe a biologic drug called dupilumab . You might also try light therapy using ultraviolet light.

    Psoriasis treatment is either systemic, which means it affects your entire body, or topical, which goes on your skin. If your disease is limited, or mild, you may be able to control it with topical corticosteroids and emollients.

    Light therapy paired with methotrexate, cyclosporine, acretin, or a biologic is also an option for more severe cases. Or you could use just a biologic drug, which includes:

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    Tips To Help Nail Psoriasis

    See your healthcare provider to find out what treatment is right for you. They may prescribe medications, phototherapy or steroid injections to help. You can also follow these simple steps to help prevent damage to the affected nails:

    • Keep your nails short
    • Wear gloves to protect fingernails when required
    • Leave your cuticles alone – dont clip them or push them back
    • Dont dig under loose nails
    • Keep your nails moisturized

    Difference Between Nail Psoriasis And A Fungal Nail Infection

    Onychomycosis or commonly known as nail fungus, in addition to odor and localized inflammation, an accurate way to differentiate ungueal psoriasis from fungal nail infection is the color of the spots that both diseases generate:

    while psoriasis produces eminently whitish discoloration in tiny or more significant spots, fungus turns nails yellowish orange and brownish when the infection has advanced.

    To treat onychomycosis is necessary to make a culture to detect the type of fungus and the sensitivity of this for different kinds of antifungal therapy.

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    Nail Psoriasis Vs Fungus Symptoms

    While symptoms of these conditions are quite similar, there are a few key differences between them.

    Nail Psoriasis Symptoms

    • Nail pitting, thickening, or deformation
    • Yellowing or browning of the nails
    • Tenderness or pain if there is buildup under the nails
    • Nail detachment from the nail bed

    Nail Fungus Symptoms

    • Progressive distortion in shape

    The Symptoms Of Psoriasis Might Not Be Localised At The Nails:

    What’s the Difference Between Eczema and Psoriasis?

    To be perfectly honest with you, nail psoriasis might be a misnomer. While it is true that the condition affects nails the most in this instance, they are not the only organs that it affects. If you encounter any of the other symptoms along with the deformed nails, then these can point to psoriasis. These symptoms are as follows:

    • Itchy and dry patches of skin around the legs
    • The patches are also red and scaly
    • There are rawness and smoothness associated with the patches.
    • There are tiny bumps of patches that can either be on the chest or the back of your body.
    • There can also be patches that are of silvery nature.

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    At What Age Do They Start

    Eczema usually starts in babies or young children. Often, symptoms improve when a kid becomes a grown-up.

    It’s less common, but possible, to get it as an adult. When that happens, it’s usually because you have another condition like thyroid disease, hormone changes, or stress.

    Psoriasis, on the other hand, usually shows up between ages 15 and 35. But you can get it at other ages too. It’s rare for a baby to have it.

    Prevention Of Nail Psoriasis

    Good nail care is the best way to treat nail psoriasis. Try these prevention tips:

    • Keep your nails trimmed short.
    • Use a nail file to keep nail edges smooth.
    • Wear gloves to clean and do other work with your hands.
    • Moisturize your nails and cuticles every day and after they’ve been in contact with water.
    • Wear comfortable shoes with enough room for your toes.

    If you’re unhappy with the way your nails look, try nail varnish or artificial nails. They can also protect your nails from more damage. Some people are sensitive to the chemicals in varnish and nail adhesive. Talk to your doctor about whether these are right for you.

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    The Best Treatment For Nail Fungus

    Combining several therapies is usually the best option: laser therapy is an excellent choice associated with topical or oral treatments.

    Is recommended to use a staggered treatment. That is, start with topical medication and if theres a recurrence, start taking oral meds.

    Finally, we must redo lab test to make sure the therapy has been successful. Its crucial that the patient knows that the nail appearance wont be the same for a while, even though the culture comes back negative.

    Risk Factors For Nail Psoriasis And Nail Fungus

    Which skin disease is it?

    Fungi are microscopic organisms that thrive in damp, warm settings. Showers and swimming pools are two of their favorite locations to hide. Any gap between your nail and the nail bed is an invitation for fungus to invade. They can even get in through small cuts in your skin. With age, you’re more likely to develop nail fungus. Men are more likely than women to get nail fungus, especially if they have a family history of fungal diseases. Additionally, according to the National Psoriasis Foundation, about 50% of people with psoriasis and over 80% of people with psoriatic arthritis have nail-related medical issues. You’re also more likely to get nail fungus if you

    • Sweat profusely
    • Work in a humid setting where your hands or feet are frequently wet
    • Walk barefoot around public pools, gyms, and showers
    • Wear socks and shoes with insufficient ventilation
    • Live with a person suffering from nail fungus
    • Have an immunosuppressive health condition such as HIV

    People with circulatory issues or diabetes are also more vulnerable. Any injury to the nail bed can increase your risk of developing nail fungus. With nail psoriasis, it’s unclear why some people with psoriasis have problems with their nails while others dont.

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    Difference Between Nail Psoriasis And Nail Fungus

    There are high chances of getting confused between nail psoriasis and nail fungus. They have many similarities. Hence, it becomes important to tell them apart for correct diagnosis and treatment.

    Symptoms of Nail Fungus

    Deformation and thickening of nails

    Pitting, deformation and thickening if nails

    Darkening of the nails

    Small red or white spots appear on the nail bed

    Nail shape can get distorted

    Nails turn yellow or brown in color

    Brittle and dull nails

    Debris build up underneath lifting the nail from its bed

    Foul-smelling

    Nails detaches from the bed and creates empty spaces in between

    Discharge may be present in some cases

    It can be painful

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