Nail Psoriasis
by Edward F. Group III, DC, ND, DACBN
updated on 04/28/2006 at 05:14PM
Psoriasis is a chronic skin condition that affects about seven million people in the United States. Psoriasis can affect any part of the skin including the scalp and the nails. Approximately ten to fifty-five percent of all patients who suffer from psoriasis also develop nail psoriasis. This condition is characterized by nail disfigurement in the form of lesions, pitting, whitening, crumbling, or splitting.
Nail psoriasis affects both men and women of all ages; however the incidence of the disease increases with age. Psoriasis can affect any part of the nail unit. Most changes occur in the nail plate. When psoriasis affects the nails they can become very deformed which can lead to enormous embarrassment. Severe psoriatic nail disease can lead to functional and social impairments if left untreated.
What Causes Nail Psoriasis?
The exact cause of nail psoriasis is not completely known. Many health experts believe that this condition occurs as the result of a combination of genetic, environmental, and immune factors.
What Are The Symptoms of Nail Psoriasis?
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Oil Drop or Salmon Patch: This lesion occurs on the nail bed. It is a translucent, yellow-red discoloration that resembles a drop of oil beneath the nail plate. This patch is the most diagnostic sign of nail psoriasis.
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Pitting: Pitting usually occurs on the proximal nail matrix. It develops due to the loss of parakeratotic cells from the surface of the nail plate.
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Beau Lines: Beau lines tend to develop on the proximal nail matrix. These lines are transverse lines in the nails that develop as a result of intermittent inflammation.
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Leukonychia: This condition occurs on the nail midmatrix. It is characterized by a whitening on areas of the nail plate.
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Subungual Hyperkeratosis: Subungual hyperkeratosis affects the nail bed and the hyponychium.
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Onycholysis: Onycholysis develops on the nail bed and nail hyponychium. It is a white area of the nail plate that develops when the nail plate becomes separated from the nail bed. It usually causes a dramatic uplifting of the nail plate. Onycholysis can result in secondary microbial infections.
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Nail Plate Crumbling: Nail psoriasis can cause the nail plate to become weakened, resulting in a crumbling of the nail plate.
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Splinter Hemorrhage: Splinter hemorrhages are black lines that develop longitudinally between the nail bed and the nail plate.
How Can Nail Psoriasis Be Prevented?
In order to prevent the development or aggravation of nail psoriasis, one should be careful to keep their nails dry and protect them from trauma and injury. Nail polish can also be used to conceal the pitting and onycholysis seen in psoriasis of the nails.
