Psoriasis is a chronic autoimmune skin disorder that affects 2 to 4 percent of the population, according to MDderma.com. Besides experiencing symptoms of itchy, scaly patches of skin, some psoriasis patients develop arthritis, and many have problems with their nails. One of the nail conditions connected with psoriasis is called oil spots.
Causes
Psoriasis appears to have a genetic component, as about 30 percent of psoriasis patients have a family history of the condition, according to an article published in the February 15, 2006 issue of "American Family Physician." Environmental factors can also trigger the development of psoriasis in susceptible individuals. Psoriasis typically causes an excessively rapid turnover of skin cells that leads to an accumulation of dead cells in irritated, itchy red patches with silvery scales. Nail changes such as oil spots occur in up to 50 percent of psoriasis patients, according to the National Psoriasis Foundation, or NPF.
Symptoms
Psoriatic nail changes can include pitting, deformation, discoloration and separation of the nail from the skin, known as onycholysis. Yellowish-brown spots caused by cellular debris under the nail from nail disintegration are called oil spots. A study published in the November 15, 2009 issue of "Dermatology Online Journal" notes that nail degeneration can be severe, with swelling, prominent oil spots, crumbling and nail destruction, and it can affect all 20 nails at once.
Who It Affects
Older people who have had psoriasis for a long time and who have extensive skin lesions have more nail changes, according to the 2006 AFP article. Some people also develop joint pain associated with psoriasis, known as psoriatic arthritis, and at least 80 percent of these individuals develop nail problems as well, notes the NPF.
Treatment Difficulties
Research appearing in the January-February 2008 issue of "Actas Dermosifiliograficas" explains that nail psoriasis has traditionally been one of the most difficult symptoms to treat. Psoriasis affects the nail during its formation, and the nail bed is difficult to penetrate with topical treatments, explains the NPF.
Prevention
To prevent oil spots and other nail problems, keep your nails as short as possible, trimming them back with manicure scissors, advises the NPF. Any part of the nail not firmly attached to the nail bed can be injured when it rubs against surfaces. Protect your nails from damage, because trauma tends to stimulate or worsen nail psoriasis. Wearing artificial nails can prevent nail damage.
Treatment
Treatments for nail psoriasis include phototherapy, corticosteroid injections into the affected nails, and surgical removal. The 2008 "Actas Dermosifiliograficas" article notes that topical therapy with vitamin D and A derivatives and nail lacquer containing 8 percent clobetasol propionate is beneficial. A study published in the journal "Dermatology" in 1999 says topical application of the medication 5-fluorouracil on affected nails has been shown to help clear symptoms, and the "Dermatology Online Journal" article found that the drug methotrexate taken in a weekly low dose could be helpful for cases involving severe nail deformation.
References
- MDderma.com: Frequently Asked Questions on Psoriasis
- American Family Physician: Chronic Plaque Psoriasis
- Dermatology: Dystrophic Psoriatic Fingernails Treated with 1-Percent 5-Fluorouracil in a Nail Penetration-Enhancing Vehicle
- National Psoriasis Foundation: Hands and Feet
- Actas Dermosifiliograficas: Diagnosis and Management of Nail Psoriasis
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