What is nail psoriasis? Causes, symptoms and treatment
Since childhood, we all have been told to keep our nails clean, so that nail diseases can be avoided and we can remain healthy. Women are more ahead than men in cleaning nails and for this they also use many types of products. But quite often some problems related to nails occur, one of which is nail psoriasis. In this article we will learn about nail psoriasis in detail. In the article you will also learn about the symptoms of nail psoriasis, causes of nail psoriasis, and most importantly, the treatment of nail psoriasis.
What is nail psoriasis?
Nail psoriasis or nail psoriasis is an autoimmune disease that causes your skin cells to reproduce too quickly. This is a type of psoriasis that affects the nails on your fingers and toes. Nail psoriasis usually appears along with a psoriatic rash on other parts of your body.
Who does nail psoriasis affect?
Nail psoriasis can happen to anyone. However, you may be more likely to develop nail psoriasis if you:
Are above 40 years of age.
If you are a man.
Have any previous psoriasis or a family history of psoriasis.
Psoriatic arthritis.
Is nail psoriasis a fungus?
No, nail psoriasis is not a fungus. Nail psoriasis is an autoimmune disease. Your immune system overreacts, causing new skin cells to grow too quickly.
What are the symptoms of nail psoriasis?
In case of nail psoriasis, the following symptoms may appear: –
Discoloration:- The skin under your nails (nail bed) may change color. These changes, called salmon patches or oil drop spots, may appear yellow, red, pink, or brown.
Pitting:- Your nails may have dents or pits (cupuliform depressions). They can be as large as the tip of a pin (0.4 millimeters) or the tip of a crayon (2 millimeters), and they can be shallow or deep. You may have only one or two pits on your nails, or you may have more than 10 per nail.
Changes in nail structure:- You may develop grooves that run horizontally across your nails (Beau’s lines). Your nails may become so thin that they begin to crumble. The thick layer of skin beneath the tip of your nail may also begin to peel and gradually separate from the nail bed (onycholysis), leading to the growth of nail fungus.
Some of these symptoms may result in discomfort, tenderness, or pain that may affect your comfort or ability to stand, walk, or use your hands.
What are the causes of nail psoriasis?
Nail psoriasis is an immune system problem. Normally, new skin cells grow every 28 to 30 days. However, in people with psoriasis, every three to four days new cells grow and move to the surface of the skin, causing a skin rash. In some people with psoriasis, it affects their nails in addition to their skin or other parts of their body.
Is nail psoriasis contagious?
Nail psoriasis is not contagious. You cannot spread nail psoriasis to another person through skin-to-skin contact.
How is nail psoriasis diagnosed?
Your healthcare provider or doctor can usually diagnose nail psoriasis after a physical examination. They will examine your affected areas to look for common symptoms of nail psoriasis. They will also ask about your symptoms and your family history.
Once your healthcare provider has diagnosed nail psoriasis, they may use the Nail Psoriasis Severity Index (NAPSI) to grade its severity. NAPSI uses imaginary lines to divide your nail into four even sections (quadrilaterals). Your nails receive a score of 0-4 depending on the presence of any nail psoriasis symptoms in each quadrant. Your healthcare provider will then add the scores together. A lower number means your nail psoriasis is mild, and a higher number means your nail psoriasis is more severe.
If there is any doubt about your symptoms, your healthcare provider may order a potassium hydroxide (KOH) preparation or a fungal culture to exclude a fungus as the cause of your symptoms. If those test results are not clear, a fungal test known as a periodic acid-Schiff (PAS) stain can also determine the presence of a fungus.
How is nail psoriasis treated?
Nail psoriasis is often resistant to some treatment options, so it can be challenging to manage without standard treatments. You and your healthcare provider may need to explore different treatment options, including:
Corticosteroids: Your healthcare provider may prescribe corticosteroid cream, ointment, or nail polish. For corticosteroids to effectively treat your nail psoriasis, they must reach the nail bed and the area of your fingers where nails begin to grow (the nail matrix), which can be difficult. You may have to apply the medication up to twice a day, and you may not see noticeable improvement for at least four to six months.
Medicine injections:- In more severe cases of nail psoriasis, your healthcare provider may use a thin needle to inject medicine into the skin around your nails. These medications may include etanercept, or adalimumab.
Oral medicines:- In more severe cases of nail psoriasis, your healthcare provider may prescribe liquid medicines or pills or tablets that you swallow with water. These medications may include methotrexate, cyclosporine, or apremilast.
Phototherapy:- Phototherapy uses ultraviolet light from special lamps. Your healthcare provider may use a medication called psoralen combined with ultraviolet A (PUVA) or ultraviolet B (UVB). The ultraviolet light waves in phototherapy may help some skin and nail disorders, including nail psoriasis.
Laser therapy: Your healthcare provider may use a pulsed dye laser (PDL) to target the blood vessels under your nails, which may reduce the severity of nail psoriasis. Laser therapy treatments usually occur every six months.
Are there any other complications of nail psoriasis?
If you have nail psoriasis, you may be at higher risk of:
Is there any way to prevent nail psoriasis?
There is no way to prevent nail psoriasis. If you have nail psoriasis, it may come and go throughout your life. Treatment can reduce symptoms even in people with severe nail psoriasis.
Can nail psoriasis go away on its own?
There is no cure for nail psoriasis. It is a long-lasting (chronic) condition, meaning flare-ups may occur throughout your life. You may have more flare-ups when the symptoms go away. Treatments may provide relief for your symptoms.