Give Your Nails Some Tlc
Dry nails or minor nail injuries can happen to anyone, but when you have nail psoriasis, they can trigger a flare-up.
Keep your nails short so they dont catch on anything. Wear gloves when youre cleaning or working with your hands. Stop biting your nails! Avoid cutting your cuticles or scraping the buildup under your nails.
Articles On Psoriasis Locations
If you have psoriasis and you notice some changes in your nails, there are many treatments you can turn to for help.
Nail psoriasis alters the way your toenails and fingernails look. They may get thick, develop pinprick holes and change color or shape. They also can feel tender and hurt.
You can treat these problems with medicine. Cosmetic repairs can make your nails look better.
Take Care Of Your Feet
Start by taking good care of your feet. Wash them regularly with a gentle soap that does not dry the skin or trigger flares. Your doctor can offer medical advice to help you find a soap that will work for you. If you are particularly prone to outbreaks of psoriasis on your feet, an oatmeal foot bath may also soothe your skin.
When your feet are clean and dry, use a gentle moisturizer to keep your feet well hydrated. Some lotions with urea or salicylic acid are specifically designed for people diagnosed with psoriasis.
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Drugs That Target Your Immune System
Unlike the above group of medications, some drugs interject with your immune system to suppress the symptoms of Psoriasis. Such drugs are usually called immunosuppressants.
If you take drugs belonging to the above category, they work by inhibiting the normal functioning of your immune system and also slow down it. This reduces the inflammation and prevents the symptoms from getting worse.
Some of the commonly prescribed immunosuppressants for Nail Psoriasis are:
- Methotrexate
- Cyclosporine
You must note that these drugs come with side effects that can cause adverse effects on you. Hence a proper doctor consultation is necessary before taking them.
What Causes Nail Psoriasis
Psoriasis is a multifactorialsystemic disease including inflammation and epidermalhyperproliferation.
Nail psoriasis can involve the nail bed, nail matrix, hyponychium, and nail folds.
Theories include:
- Activation of the antimicrobialpeptide LL-37 by Candida and the cytokine overflow theory
- Increased expression of interleukin-10 in the affected nail bed compared to downregulation of IL-10 in psoriatic skin lesions
- Koebnerisation of psoriasis in onychomycosis or nail trauma.
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Treatment Options For Nail Psoriasis And Nail Fungus
Since the root causes of nail psoriasis and nail fungus are different, the ways theyre both treated are also different.
For nail fungus, youre trying to treat an infection, so youre using antifungals, topically or orally, says Dr. Braue. Psoriasis is inflammatory, so youre trying to quell the immune response and calm that inflammation. In those cases, youre using things like steroids.
If youre noticing signs of nail psoriasis or nail fungus, you should see your healthcare provider, who can accurately diagnose exactly what it is youre dealing with. Theyll then prescribe ointments or medication and in some cases, a combination of both. Treatments may last anywhere from a couple of months to a full year, as you need to give your body time to rid itself of the infection or to regrow healthy nails. As a healthy nail grows over time, its important to trim the unhealthy or infected part of the nail off. If youre experiencing pain, consider wearing more comfortable, loose-fitting shoes until youre fully healed.
Occasionally, you can get steroid injections though, these tend to hurt when given in such a sensitive spot like your feet to speed up the process, or you may be able to seek out cosmetic options such as laser or surgical removal.
Pathophysiology Of Nail Psoriasis
The pathogenesis of the psoriatic nail disorder is not completely known. Nail psoriasis may be due to a combination of genetic, environmental, and immune factors. A well-known fact is that a familial aggregation of psoriasis exists. Studies have linked psoriasis with certain human leukocyte antigen subtypes . A T-cellmediated inflammatory process is being investigated as part of the pathogenesis of psoriasis.
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Nail Psoriasis Causes And Symptoms
Nail psoriasis causes are not known, however, it is believed to be connected to genetic, immunologic, and environmental factors. This is why it tends to run in families especially if both parents suffer from the condition despite the fact that it is not contagious.
As mentioned above, its very uncommon that nails will be the only part of the body affected by psoriasis. Therefore, in addition to the symptoms of plaque psoriasis, here are the most common nail psoriasis symptoms:
- pitting, which involves dents or holes forming in the nail
- grooves across the nail
- a change in the nails shape or thickness
- crumbling nails
- Discoloration
Regardless of whether the symptoms are mild or severe, they can have a physical and emotional effect on a person and affect their quality of life just the same. This is especially true in cases where the nail splits or pulls away from the finger as certain tasks, such as sewing, become increasingly difficult to perform.
Generalised Pustular Psoriasis Or Von Zumbusch Psoriasis
This causes pustules that develop very quickly on a wide area of skin. The pus consists of white blood cells and is not a sign of infection.
The pustules may reappear every few days or weeks in cycles. During the start of these cycles, von Zumbusch psoriasis can cause fever, chills, weight loss and fatigue.
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Is Psoriasis The Same As Eczema
Psoriasis and eczema are two different skin conditions. They differ in where the disease appears on the body, how much it itches and how it looks. Eczema tends to appear more often behind the knees and inside the elbows. Eczema also causes more intense itching than psoriasis. Many people, especially children, can get both eczema and psoriasis.
This is the most common form, accounting for about 80 to 90% of cases.
Its symptoms are dry red skin lesions, known as plaques, covered in silver scales.
They normally appear on your elbows, knees, scalp and lower back, but can appear anywhere on your body.
The plaques can be itchy or sore, or both. In severe cases, the skin around your joints may crack and bleed.
What Nail Psoriasis Looks And Feels Like
As with all types of psoriasis, nail psoriasis is caused by inflammation, says Dr. Garshick. That inflammation can impact the nail matrix the area beneath the cuticle where the nail starts which can affect how the nail grows out. The soft tissue underneath the nail can also be affected, as can the skin around the nail, which can easily be mistaken for other nail conditions, such as an injury to the affected nails or a fungus.
Nail psoriasis symptoms largely arent painful, just noticeable, although Some people can experience tenderness or sensitivity, Garshick says. The symptoms of nail psoriasis can include:
- Nail pitting This refers to tiny dents that form on the surface of the nail.
- Nail crumbling The nails themselves can start to break apart, which can affect day-to-day functions such as using a computer keyboard.
- Onycholysis, or lifting of the nail away from the nail bed Thickening of the nail can cause it to separate from the finger or toe, which makes it more likely to catch on something and lift up or break off.
- Leukonychia, or tiny white dots on the surface of the nail Inflammation causes this discoloration.
- Salmon spots or oil spots Yellow-red discolorations form on the nail bed and look like a drop of oil under the nail.
These symptoms can appear on fingernails, toenails, or both, but not every fingernail or toenail may be affected.
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What Is Nail Psoriasis
Generally psoriasis is a skin condition but it can affect your toenails and fingernails too. When it affects your toenails or fingernails it is referred to as nail psoriasis or psoriatic nail disease. When nail psoriasis starts to develop usually a person will have cutaneous or skin psoriasis. You may also have psoriatic arthritis when you have nail psoriasis. One thing to note is that it is not contagious so you can not pass it on to others through any type of contact.
Epidemiology Of Nail Psoriasis
Psoriatic nail disease occurs in 10-55% of all patients with psoriasis, and approximately 7 million people in the United States have psoriasis . Less than 5% of psoriatic nail disease cases occur in patients without other cutaneous findings of psoriasis. About 10-20% of people with psoriasis also have psoriatic arthritis, and nail changes are seen in 53-86% of patients with psoriatic arthritis.
Psoriasis tends to run in families. In Farber’s questionnaire study of 2100 patients, 36% of patients reported the presence of psoriasis in at least 1 relative. Among siblings, 8% are affected if neither parent has psoriasis. This percentage increases to 16-25% if 1 parent or sibling has the disease, and it reaches up to 75% if both parents are affected. If 1 twin has psoriasis, the other twin is at an increased risk of having psoriasis .
In Scandinavia, the prevalence rate of nail psoriasis for adults with psoriasis approaches 5%. The prevalence increases with the age of the population studied.
Psoriatic nail disease is not associated with mortality. In severe cases, patients may have functional and psychosocial impairments.
Males and females are affected equally by nail psoriasis, and the prevalence of nail psoriasis increases with the age of the population studied.
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How Topical Medicine And Injections Work To Fight Nail Psoriasis
If your psoriasis is confined to the nail bed , topical steroids, vitamin D3 analogue ointments and retinoid creams or gels can be effective.
But psoriasis typically goes deeper, affecting the nail matrix . While topical treatments dont penetrate the matrix of the nail, steroids can be safely injected around the nail with good efficacy.
These injections are both safe and effective in reducing the pitting, hardening, ridging and discoloration, as well as nail separation caused by nail psoriasis, says Dr. Kassouf.
Dermatologists usually administer injections monthly, then reassess the nails to see if further treatments or dosage changes are needed.
If you cant tolerate or dont respond to injections, oral medications are occasionally used especially when you have psoriasis-related arthritis or significant skin changes.
Nail Infection Needs Treatment Too
A nail infection can develop if you have nail psoriasis. Because a nail infection can look a lot like nail psoriasis, its important to find out if you have an infection. Testing, which usually consists of scraping the nail, can find an infection. If you have a nail infection, treatment can get rid of it.
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Ringworm: Fungal Infections Of The Skin And Nails
Tinea is a type of fungal infection that resembles some symptoms of psoriasis. Psoriasis can cause the thick fingernails symptomatic of fungal nail infections, and both can cause red, itchy skin rashes. When tinea grows on your skin, it can cause a scaly, red skin rash that clears in the middle, called ringworm . Fungal infections of the skin and nails can be hard to treat. Antifungal medications work, but you may need to take them for a long time.
What Does Psoriasis Look Like Generally
A quick summary: Psoriasis is a skin condition that affects about 2-3% of the population. It can cover a small part of your body or emerge as a full-body condition, depending on the type. It can appear in areas that are exposed or unexposed . In its most common form, you develop thick, red, scaly patches of skin called plaques. They can look silvery and can itch, like, whoa.
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Is Nail Psoriasis Serious
Psoriasis on the hands and feet can significantly impact your quality of life because of the way the disease may impair the use of the hands and feet. The pain from palmoplantar psoriasis may limit mobility and keep you from working or doing daily tasks.
What are the early warning signs of psoriatic arthritis? 11 Early Signs of Psoriatic Arthritis
- Joint pain or stiffness.
- Foot pain.
What is the white crusty stuff under my toenails?
Nail psoriasis sometimes causes too much keratin to grow under the nail. This overgrowth is called subungual hyperkeratosis. People with hyperkeratosis may notice a white, chalky substance under the nail. When this occurs in the toenails, the pressure of shoes pushing down on the nails might cause pain.
Does nail psoriasis spread? 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.
What Are Nail Psoriasis Symptoms And Signs
Usually, people who have nail psoriasis also have skin symptoms, too. If someone has psoriasis of the nails but does not have skin symptoms, the condition may be difficult for a doctor to diagnose, since the signs of psoriasis of the nails resemble those of fungal infection of the nails. It is important to inform the doctor if there is a family history of psoriasis.
The nail unit is made up of a nail plate, nail bed, hyponychium, nail matrix, nail folds, cuticle, anchoring portion, and ends of the finger bones. See each of these structures in images 1-2.
Someone might notice the following signs with psoriatic nails:
Nail psoriasis can also occur together with fungal infections of the nail and inflammation of the skin around the edges of the nail .
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Home Remedies For Facial Psoriasis
At-home self-care is about the basics â trying not to scratch affected areas, avoiding the things that seem to trigger flare-ups, using cold compresses and moisturizer to soothe affected areas , and keeping up with your treatment.
No supplements or herbal remedies have been proven to treat psoriasis on the face or any other part of the body.
How Is Toenail Psoriasis Treated
Unfortunately, not many good treatment options exist for toenail psoriasis. Conservative treatment usually begins with topical corticosteroid creams or ointments, or non-steroidal alternatives such as Tazorac and Dovonex.
The drawback to these creams and ointments is that they may not penetrate the nail plate adequately. Also, long-term steroid use can cause the skin and nails to thinwhich takes months to grow out.
Another treatment option is phototherapy. This involves treating the nails with topical or systemic psoralen compounds, which cause the nail to respond to ultraviolet light.
According to some experts, the best treatment involves intralesional steroid injections. This means injecting cortisone into the base of the nail and into the nail folds alongside it. This treatment can be effective, and when done properly it is not as painful as it sounds.
Proper care of your feet and nails is vitally important if you have psoriasis. Avoid getting pedicures, as nail salon personnel often treat the nails roughly, and many of them trim cuticles, , which allows bacteria to enter the nail , and is especially bad for persons affected with toenail psoriasis.
Keep your toenails short to avoid injury, and try to keep the nail folds clean and dry. Above all, one of the best treatments for psoriatic nails is control of your overall psoriasis.
Medical References:
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Treatments Done At The Office
If your nail changes are more severe or if you have a lot of nails involved getting a stronger treatment at your providers office may help. You can do this in combination with topical treatments. Here are some common office treatments:
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Corticosteroid injections use a small needle to put medication directly in or around your nails.
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Laser treatments use different wavelengths of light targeted directly on your nails.
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Psoralen and ultraviolet A which uses light treatments on your nails combined with psoralen .
Conditions With Similar Symptoms
Nail psoriasis can resemble a fungal infection, such as onychomycosis. This also causes the nails to thicken. Moreover, onychomycosis often occurs alongside nail psoriasis. This can make diagnosis difficult.
Getting a correct diagnosis is important because the treatment for a fungal infection is different from the treatment for nail psoriasis. Anyone with psoriasis and changes in their nails should make sure that their doctor is aware of their psoriasis.
Nail psoriasis does not always cause physical pain, but some people may find it unsightly, and it can cause embarrassment. Treatment can prevent it from worsening.
Treatments include:
- topical medicines, such as creams applied directly to the nails
- systemic medications, which affect the whole body
- intralesional therapies, which involve a doctor injecting medication into the nail bed
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Does Psoriasis Affect Your Nails
Nails. Nail psoriasis normally affects several digits and is more common on the fingernails than the toenails. Pain and tenderness from nail psoriasis can impact daily activities. Nail psoriasis may be an indicator of psoriatic arthritis , as many people have both.
Do thyroid problems cause nail ridges? Horizontal ridges can be caused by trauma to the nail and may be deep or discolored. The can also indicate malnutrition, psoriasis or a thyroid problem. Check with your doctor if you see horizontal ridges on your nails they may indicate a more serious problem.
What Vitamin Are you lacking when you have ridges in your nails?
With the abundance of food in the United States, you may think of nutrient deficiencies as a problem of undeveloped countries, but low intakes due to poor diet or absorption issues are not uncommon. A deficiency in vitamin A, or the minerals calcium and zinc may cause ridges to appear on your nails.
What do Beauâs lines look like? Beauâs lines are horizontal depressions in the nail plate that run parallel to the shape of the white, moon-shaped portion of the nail bed seen at the nailâs origin. They result from a sudden interruption of nail keratin synthesis and grow distally with the nail plate.
