Psoriasis, a chronic, inflammatory disease involving the skin and joints, affects almost 2 percent of the population, according to the American Academy of Dermatology article titled, "Guidelines of Care for the Management of Psoriasis and Psoriasis Arthritis." About 50 percent of psoriasis suffers, with active psoriasis, will develop changes in the nails, especially those with psoriatic arthritis, notes Psoriasis Net. Fingernails and toenails become a challenge to manage when affected by psoriasis.
Nail Changes
Psoriatic nails vary in appearance based on the part of the nail affected. For example, when psoriasis damages a nail bed, the nail has a clear yellow-red discoloration that gives the appearance of oil under the nail, notes DermNet NZ. Damage to the proximal nail matrix causes deep pitting and transverse lines on nail surfaces; both due to inflammation stopping growth lines. Damage to the hyponychium, or epidermis cells beneath the nail plate, can lead to onycholysis, a loosening or separation of a fingernail or toenail from the nail bed. A nail with this condition will have irregular borders, whitish outside edges and may appear a yellow-green color. Thickened skin may develop underneath the edges of the nail plate, mentions DermNet NZ. Onycholysis can occur at any age, to any race and either sex.
Treatment
DermNet NZ claims there is no cure for nail psoriasis; the condition may improve on its own. On occasion, some nails will return to normal appearance. Psoriasis affects the nail when it is being formed, making it challenging to successfully treat. Some available treatment options include applying calcipotriol solution two times a day for an extended period of time; using topical high-potency corticosteroids wrapped with cellophane at bedtime; injections with triamcinolone acetonide, into nail folds; however, this is quite painful, notes DermNet NZ. Psoralen and UVA phototherapy combined or phototherapy by itself has been effective in some cases. Oral methotrexate, used for treating overall psoriasis, is promising with nail psoriasis.
Routine Nail Care
Psoriasis patients can help prevent nails from becoming damaged, possibly triggering nail psoriasis, by keeping their nails trimmed back to short lengths; this prevents nails from rubbing up against surfaces and damaging portions of the nail bed. DermNet NZ suggests keeping nails dry, avoiding contact with irritants such as nail polish and remover; avoiding contact with detergents and solvents and wearing cotton gloves under vinyl gloves when performing wet work.
