Psoriasis toenails. Nail Psoriasis: Symptoms, Treatments, and Management Strategies

19.08.202323.06.2023 by alexxlab

What are the common symptoms of nail psoriasis. How is nail psoriasis diagnosed and treated. Can nail psoriasis be effectively managed with topical treatments. What are the long-term effects of nail psoriasis on overall health.

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Understanding Nail Psoriasis: Causes and Prevalence

Nail psoriasis is a manifestation of the inflammatory autoimmune disease psoriasis, which affects millions of people worldwide. While psoriasis is primarily known for causing skin symptoms, it can also have a significant impact on the nails. In fact, up to 82% of individuals with psoriasis may experience nail changes, and approximately 80% of those with psoriatic arthritis develop nail abnormalities.

The exact cause of nail psoriasis remains unclear, but researchers believe it is related to the overproduction of skin cells and inflammation characteristic of psoriasis. In rare cases, nail psoriasis may be the only visible sign of the condition, though most individuals with nail involvement also have skin symptoms elsewhere on their body.

Recognizing the Signs: Common Symptoms of Nail Psoriasis

Nail psoriasis can manifest in various ways, with symptoms ranging from mild to severe. Understanding these signs is crucial for early detection and management. Here are some of the most common symptoms:

Pitting

One of the hallmark signs of nail psoriasis is pitting, which appears as small depressions on the nail surface. These pits can vary in number, size, and depth, giving the nail a dimpled appearance. Why does pitting occur? The condition causes the nail plate to lose cells, resulting in these characteristic indentations.

Changes in Nail Shape and Thickness

Nail psoriasis can lead to significant alterations in the structure and appearance of the nails. Some individuals may experience nail crumbling due to weakness in the supporting structures. In other cases, nails may become thicker, a condition known as subungual hyperkeratosis. This thickening can be uncomfortable and may make everyday tasks more challenging.

Nail Bed Separation

Onycholysis, or the separation of the nail from the nail bed, is another common symptom of nail psoriasis. This separation typically begins at the tip of the nail and may progress towards the cuticle. A yellow discoloration often accompanies this separation, and the affected area can be prone to bacterial infections.

Discoloration

Nail psoriasis can cause various color changes in the affected nails. These may include:

Yellow-red patches in the nail bed (oil-drop spots)
Reddening of the lunula (the half-moon shape at the base of the nail)
Narrow, reddish-purple lines (splinter hemorrhages)
Yellow-brown discoloration of the entire nail

Blood Spots

Some individuals with nail psoriasis may develop small blood spots under the nail, known as splinter hemorrhages. These appear as narrow, elongated deposits and are caused by tiny blood vessels breaking beneath the nail plate.

Rough Texture

In rare cases, nail psoriasis can cause a condition called trachyonychia, where the nails develop a rough, sandpaper-like texture. This can affect one or all nails and may be particularly noticeable on the fingernails.

Diagnosing Nail Psoriasis: What to Expect

Diagnosing nail psoriasis typically involves a thorough examination by a dermatologist or rheumatologist. The healthcare provider will assess the appearance of the nails and may ask about other psoriasis symptoms or family history. In some cases, additional tests may be necessary to rule out other nail conditions or fungal infections.

How can you differentiate nail psoriasis from other nail disorders? While some symptoms may overlap with other conditions, the combination of multiple signs, along with a history of psoriasis or psoriatic arthritis, often points towards a diagnosis of nail psoriasis. However, a professional evaluation is essential for an accurate diagnosis and appropriate treatment plan.

Treatment Approaches: Managing Nail Psoriasis Effectively

Treating nail psoriasis can be challenging, and it often requires patience and persistence. The choice of treatment depends on several factors, including the severity of symptoms, the number of affected nails, and the individual’s overall health. Here are some common treatment approaches:

Topical Medications

Topical treatments are often the first line of defense against nail psoriasis. These medications are applied directly to the affected nails and surrounding skin. Common topical treatments include:

Corticosteroids (e.g., clobetasol propionate, betamethasone dipropionate)
Vitamin D analogues (e.g., calcipotriol, calcipotriene, calcitriol)
Retinoids (e.g., tazarotene)
Anti-inflammatory ointments (e.g., anthralin)

How effective are topical treatments for nail psoriasis? While they can provide relief for some symptoms, topical treatments may have limited efficacy for severe cases or when the nail matrix is involved. It’s important to note that improvement may take several months to become noticeable.

Systemic Medications

For more severe cases or when topical treatments prove ineffective, systemic medications may be prescribed. These are taken orally or administered via injection and work throughout the body to address the underlying inflammation. Common systemic treatments include:

Methotrexate
Cyclosporine
Oral retinoids
Biologic drugs (e.g., TNF-alpha inhibitors, IL-17 inhibitors)

Systemic treatments can be highly effective but may come with more significant side effects. Close monitoring by a healthcare provider is essential when using these medications.

Intralesional Injections

In some cases, dermatologists may recommend intralesional corticosteroid injections directly into the nail bed or matrix. This targeted approach can help reduce inflammation and improve nail appearance. However, these injections can be painful and may not be suitable for all patients.

Phototherapy

Ultraviolet (UV) light therapy, particularly narrowband UVB or PUVA (psoralen plus UVA), may be beneficial for some individuals with nail psoriasis. This treatment can help reduce inflammation and slow the growth of affected skin cells.

Lifestyle Modifications and Self-Care Strategies

In addition to medical treatments, certain lifestyle changes and self-care practices can help manage nail psoriasis and prevent complications:

Keep nails short and well-trimmed to reduce the risk of injury and infection
Avoid picking or manipulating affected nails
Wear protective gloves when working with water or chemicals
Moisturize nails and surrounding skin regularly
Practice good nail hygiene to prevent infections
Consider using nail polish to camouflage discoloration (if approved by your dermatologist)

Can dietary changes help manage nail psoriasis? While there’s no specific diet proven to cure nail psoriasis, some individuals find that reducing inflammatory foods and increasing omega-3 fatty acids may help alleviate symptoms. However, it’s essential to consult with a healthcare provider before making significant dietary changes.

The Impact of Nail Psoriasis on Quality of Life

Nail psoriasis can have a significant impact on an individual’s quality of life, affecting both physical function and emotional well-being. The visible nature of nail changes may cause embarrassment or self-consciousness, potentially leading to social isolation or reduced participation in activities.

Moreover, severe nail psoriasis can interfere with daily tasks, making it difficult to perform fine motor activities or causing discomfort when wearing shoes. Understanding these challenges is crucial for healthcare providers to offer comprehensive care that addresses both the physical and psychological aspects of the condition.

Emerging Treatments and Future Directions

Research into nail psoriasis continues to evolve, with new treatments and management strategies on the horizon. Some promising areas of investigation include:

Novel biologic therapies targeting specific inflammatory pathways
Improved drug delivery systems for topical treatments
Combination therapies to enhance efficacy and reduce side effects
Gene therapy approaches to address the underlying genetic factors of psoriasis

As our understanding of the condition grows, so too does the potential for more effective and personalized treatment options. Patients with nail psoriasis should stay informed about these developments and discuss emerging treatments with their healthcare providers.

Living with Nail Psoriasis: Long-Term Management and Outlook

Managing nail psoriasis is often a long-term endeavor requiring patience and persistence. While complete cure may not always be possible, many individuals can achieve significant improvement in their symptoms with appropriate treatment and care. Key aspects of long-term management include:

Regular follow-up appointments with a dermatologist or rheumatologist
Consistent adherence to prescribed treatments
Monitoring for signs of psoriatic arthritis, which can be associated with nail psoriasis
Addressing any psychological impacts through counseling or support groups
Maintaining overall health through a balanced diet, regular exercise, and stress management

What is the long-term outlook for individuals with nail psoriasis? While the condition can be chronic, many people experience periods of remission with proper treatment. The key is to work closely with healthcare providers to develop a personalized management plan that addresses individual needs and goals.

In conclusion, nail psoriasis is a complex condition that requires a multifaceted approach to diagnosis, treatment, and management. By understanding the symptoms, exploring treatment options, and implementing self-care strategies, individuals with nail psoriasis can effectively manage their condition and maintain a good quality of life. As research continues to advance, the future holds promise for even more effective treatments and improved outcomes for those living with nail psoriasis.

Nail Psoriasis: Pictures, Symptoms, and Treatments

Psoriasis is an inflammatory autoimmune disease that usually causes your body to produce too many skin cells, which can form thick, itchy, scaly patches on the skin. It can also affect your joints and the appearance and texture of your nails — fingernails more often than toenails.

Psoriasis can occur anywhere on the skin, but is typically found on the:

elbows
knees
lower back
scalp

Around 7.4 million people in the United States have psoriasis. Up to 82 percent of people with psoriasis may experience nail changes. And around 80 percent of people with psoriatic arthritis, a related joint condition, develop nail changes as well. Doctors aren’t sure why this happens to some people and not others.

In rare cases, the nails are the only parts of the body that show signs of psoriasis. But usually, people with psoriasis have a rash on other parts of their body as well.

Nail psoriasis can look different in each person. Symptoms may range from mild to severe.

Pitting

The nail plate is the hard surface that sits over the nail bed. It’s made of keratin, which is a hardened protein found in skin and hair cells.

Nail psoriasis causes your nail plate to lose cells. This results in small pits forming on your fingernails or toenails, which may look like your nails were hit with the tip of a pen. The number of pits varies from person to person.

Some people may have only a single pit on each nail, while others have dozens of pits. The pits can be shallow or deep.

Changes in nail shape or thickness

In addition to pitting, weakness of the structures that support nails can cause your nails to crumble. Nails can also become thicker due to a fungal infection called onychomycosis, which is common in people with psoriasis.

Additionally, your nail may get thicker because it develops a chalky substance underneath. When this happens, it’s called subungual hyperkeratosis and may be painful or uncomfortable.

Nail bed separation

Sometimes your nail can separate from the nail bed, which is the skin underneath the nail plate. This separation is called onycholysis. It leaves an empty space under your nail.

If you have nail psoriasis, you may first notice a yellow discoloration at the tip of a nail. The color and lifting of the nail may eventually go all the way down to the cuticle.

Bacteria can get into the space under the nail and cause infection, which can turn the whole nail a dark color.

Discolored nails

The color of your nail may also change. You might see a yellow-red patch in the nail bed. It looks like a drop of oil under your nail plate, which is where it gets its name: oil-drop spot.

A more severe case of psoriasis may also cause the lunula — the small, half-moon shape that appears at the bottom of your nail — to look red. This is caused by dilated blood vessels.

You may also notice very narrow, reddish-purple lines on your nails. These are called splinter hemorrhages.

Additionally, your toenails or fingernails can turn a yellow-brown color. Crumbling nails often turn white.

Blood spots

You also might develop blood spots under your nail, which are called splinter hemorrhages. These deposits are narrow and several millimeters long.

Rough nails

One or all your nails may look like sandpaper, notes Morgan McCarty, DO, a dermatologist at Austin Regional Clinic in Round Rock, Texas. This rare condition is called trachyonychia.

Dermatologists typically treat nail psoriasis with the same treatments that are used for psoriasis. The treatment that’s best for you depends on several factors.

For example, McCarty considers each person’s age and the number of nails that are affected. She also works with a rheumatologist to check for psoriatic arthritis.

Nail psoriasis can be tough to treat and treatments take time to work. As McCarty points out, it can take 4 to 12 months to see improvement in your nails for any treatment.

Many helpful treatments are available, including:

Topical medications

Dermatologists may suggest an over-the-counter or prescription topical medication. You apply topical medications directly to your nail once or twice per day.

Topical medications for nail psoriasis come in various forms, such as:

ointments
creams
emulsions
nail polishes

Topical corticosteroids, including clobetasol propionate and betamethasone dipropionate, can provide mild improvement of some psoriasis symptoms.

Topical treatments with vitamin D help reduce inflammation and slow excess skin cell production. They can relieve nail thickness by reducing cell buildup under the nails.

Vitamin D topical treatments include:

calcipotriol (Calcitreme)
calcipotriene (Dovonex)
calcitriol

Tazarotene (Tazorac) is a topical retinoid, a medication made from vitamin A. It can help with:

nail discoloration
pitting
separation

Anthralin is an anti-inflammatory ointment that slows excess skin cell production. When applied to the nail bed once daily, it improves symptoms like thickening and onycholysis — although it may temporarily discolor nails.

Corticosteroid injections

In some cases, a dermatologist may inject a corticosteroid into or near your nail. Corticosteroid injections can treat symptoms such as:

nail thickening
ridges
separation

Oral drugs

If a topical medicine doesn’t work or symptoms are more severe, “an oral prescription medicine is usually the next line of defense,” says McCarty.

Dermatologists also advise oral therapies when:

Psoriasis affects more than three nails.
The condition greatly impacts a person’s quality of life.
More than 10 percent of an individual’s body surface is covered in psoriasis or affected by psoriatic arthritis.

Because many oral medications can have some side effects, it’s important to talk with your doctor about what you should expect if you start taking one.

Systemic (body-wide) drugs work throughout your body to clear both the skin and nails in moderate-to-severe psoriasis. These drugs are available as a liquid, pill, or injection.

Systemic drugs include:

cyclosporine
methotrexate
apremilast (Otezla)
retinoids (Soriatane)

When psoriasis hasn’t responded to other treatments, biologic drugs may be a good option. Biologics are a class of newer medications that target the specific part of the immune system that is overactive due to psoriasis.

Biologics include:

adalimumab (Humira)
etanercept (Enbrel)
infliximab (Remicade)
ustekinumab (Stelara)
secukinumab (Cosentryx)
risankizumab (Skyrizi)

You receive biologic drugs by infusion or injection. Many times, the injection can be performed at home.

Because biologics suppress the immune system, taking one may make you more susceptible to infection. Talk with your doctor about what you can expect if you decide to take a biologic.

Oral antifungal drugs treat fungal infections caused by nail psoriasis.

Phototherapy

Phototherapy improves nail separation and discoloration by slowing the growth of skin cells. For nail psoriasis, the treatment is called PUVA.

PUVA exposes areas of skin affected by psoriasis to:

ultraviolet (UV) rays from the sun
a phototherapy unit at a clinic or at home
a laser

First, you soak your hands in a medication called psoralen or take it by mouth. Psoralen makes your skin sensitive to UVA light. After the medicine, you’re exposed to UVA light.

Laser treatment

Laser therapy for nail psoriasis uses the pulsed dye laser. It works by targeting blood vessels under the skin with a beam of light.

Laser therapy is most helpful for nail splitting and subungual hyperkeratosis, says McCarty.

Home treatments

A few natural remedies that are said to relieve psoriasis symptoms include:

turmeric
Dead Sea salt
aloe vera

However, there isn’t enough scientific evidence to prove any of these alternative treatments actually work.

When it comes to nail psoriasis specifically, alternative treatment options are very limited.

One herbal remedy that may help nail psoriasis is indigo naturalis, a Chinese herbal medicine that comes from the same plant used to make blue dye.

In one small study from 2015, an indigo naturalis extract in oil (Lindioil) improved nail thickening and onycholysis better than topical calcipotriol.

Because of the lack of research around this herbal medicine and most other home remedies for nail psoriasis, it’s best to discuss treatment options with your doctor before deciding on a course of action.

To prevent nail psoriasis flares, consider trying these tips:

Keep your nails short to avoid injury or lifting of the nail from its bed. Trimming your nails regularly will also help prevent buildup from collecting underneath them.
Avoid biting or picking at your nails and pushing back your cuticles. Injuries to the skin can set off psoriasis flares. This is called the Koebner phenomenon.
Wear gloves when gardening, washing dishes, or doing any kind of work in water. For the best protection, wear cotton gloves under vinyl or nitrile gloves.
Keep your nails clean and dry to prevent infection.
Use a moisturizing cream on your nails and cuticles. This can help prevent cracked or brittle nails.
Avoid cleaning your nails with a nail brush or sharp object. This will help prevent nail separation.
If you smoke, try to quit. Smoking can increase the risk of psoriasis
If you drink, try to do so in moderation, as alcohol is also associated with a higher risk of psoriasis.

If you feel self-conscious about your nails, you can alter their appearance by gently filing and buffing them and by applying polish.

Avoid fake nails, which increase the risk of your nail separating from its bed.

The National Psoriasis Foundation recommends that everyone with psoriasis connect with a dermatologist for diagnosis and treatment. If you’ve already received a diagnosis, make an appointment with your doctor if:

Your symptoms are getting worse or are bothering you.
The treatment you’re using isn’t helping.
You want to try a new therapy or alternative remedy.

Psoriasis is a common skin condition that can cause nail changes in some people. If you’ve received a psoriasis diagnosis with psoriasis and notice your nails are looking brittle or pitted, talk with your doctor about treatment options.

A variety of treatments are available for nail psoriasis, and the right one for you will depend on a few factors, including the severity of your condition.

Nail Psoriasis: Pictures, Symptoms, and Treatments

Psoriasis can occur anywhere on the skin, but is typically found on the:

elbows
knees
lower back
scalp

In rare cases, the nails are the only parts of the body that show signs of psoriasis. But usually, people with psoriasis have a rash on other parts of their body as well.

Nail psoriasis can look different in each person. Symptoms may range from mild to severe.

Pitting

The nail plate is the hard surface that sits over the nail bed. It’s made of keratin, which is a hardened protein found in skin and hair cells.

Some people may have only a single pit on each nail, while others have dozens of pits. The pits can be shallow or deep.

Changes in nail shape or thickness

Additionally, your nail may get thicker because it develops a chalky substance underneath. When this happens, it’s called subungual hyperkeratosis and may be painful or uncomfortable.

Nail bed separation

Sometimes your nail can separate from the nail bed, which is the skin underneath the nail plate. This separation is called onycholysis. It leaves an empty space under your nail.

If you have nail psoriasis, you may first notice a yellow discoloration at the tip of a nail. The color and lifting of the nail may eventually go all the way down to the cuticle.

Bacteria can get into the space under the nail and cause infection, which can turn the whole nail a dark color.

Discolored nails

The color of your nail may also change. You might see a yellow-red patch in the nail bed. It looks like a drop of oil under your nail plate, which is where it gets its name: oil-drop spot.

A more severe case of psoriasis may also cause the lunula — the small, half-moon shape that appears at the bottom of your nail — to look red. This is caused by dilated blood vessels.

You may also notice very narrow, reddish-purple lines on your nails. These are called splinter hemorrhages.

Additionally, your toenails or fingernails can turn a yellow-brown color. Crumbling nails often turn white.

Blood spots

You also might develop blood spots under your nail, which are called splinter hemorrhages. These deposits are narrow and several millimeters long.

Rough nails

One or all your nails may look like sandpaper, notes Morgan McCarty, DO, a dermatologist at Austin Regional Clinic in Round Rock, Texas. This rare condition is called trachyonychia.

Dermatologists typically treat nail psoriasis with the same treatments that are used for psoriasis. The treatment that’s best for you depends on several factors.

For example, McCarty considers each person’s age and the number of nails that are affected. She also works with a rheumatologist to check for psoriatic arthritis.

Nail psoriasis can be tough to treat and treatments take time to work. As McCarty points out, it can take 4 to 12 months to see improvement in your nails for any treatment.

Many helpful treatments are available, including:

Topical medications

Dermatologists may suggest an over-the-counter or prescription topical medication. You apply topical medications directly to your nail once or twice per day.

Topical medications for nail psoriasis come in various forms, such as:

ointments
creams
emulsions
nail polishes

Topical corticosteroids, including clobetasol propionate and betamethasone dipropionate, can provide mild improvement of some psoriasis symptoms.

Topical treatments with vitamin D help reduce inflammation and slow excess skin cell production. They can relieve nail thickness by reducing cell buildup under the nails.

Vitamin D topical treatments include:

calcipotriol (Calcitreme)
calcipotriene (Dovonex)
calcitriol

Tazarotene (Tazorac) is a topical retinoid, a medication made from vitamin A. It can help with:

nail discoloration
pitting
separation

Corticosteroid injections

In some cases, a dermatologist may inject a corticosteroid into or near your nail. Corticosteroid injections can treat symptoms such as:

nail thickening
ridges
separation

Oral drugs

If a topical medicine doesn’t work or symptoms are more severe, “an oral prescription medicine is usually the next line of defense,” says McCarty.

Dermatologists also advise oral therapies when:

Psoriasis affects more than three nails.
The condition greatly impacts a person’s quality of life.
More than 10 percent of an individual’s body surface is covered in psoriasis or affected by psoriatic arthritis.

Because many oral medications can have some side effects, it’s important to talk with your doctor about what you should expect if you start taking one.

Systemic (body-wide) drugs work throughout your body to clear both the skin and nails in moderate-to-severe psoriasis. These drugs are available as a liquid, pill, or injection.

Systemic drugs include:

cyclosporine
methotrexate
apremilast (Otezla)
retinoids (Soriatane)

Biologics include:

adalimumab (Humira)
etanercept (Enbrel)
infliximab (Remicade)
ustekinumab (Stelara)
secukinumab (Cosentryx)
risankizumab (Skyrizi)

You receive biologic drugs by infusion or injection. Many times, the injection can be performed at home.

Because biologics suppress the immune system, taking one may make you more susceptible to infection. Talk with your doctor about what you can expect if you decide to take a biologic.

Oral antifungal drugs treat fungal infections caused by nail psoriasis.

Phototherapy

Phototherapy improves nail separation and discoloration by slowing the growth of skin cells. For nail psoriasis, the treatment is called PUVA.

PUVA exposes areas of skin affected by psoriasis to:

ultraviolet (UV) rays from the sun
a phototherapy unit at a clinic or at home
a laser

First, you soak your hands in a medication called psoralen or take it by mouth. Psoralen makes your skin sensitive to UVA light. After the medicine, you’re exposed to UVA light.

Laser treatment

Laser therapy for nail psoriasis uses the pulsed dye laser. It works by targeting blood vessels under the skin with a beam of light.

Laser therapy is most helpful for nail splitting and subungual hyperkeratosis, says McCarty.

Home treatments

A few natural remedies that are said to relieve psoriasis symptoms include:

turmeric
Dead Sea salt
aloe vera

However, there isn’t enough scientific evidence to prove any of these alternative treatments actually work.

When it comes to nail psoriasis specifically, alternative treatment options are very limited.

One herbal remedy that may help nail psoriasis is indigo naturalis, a Chinese herbal medicine that comes from the same plant used to make blue dye.

In one small study from 2015, an indigo naturalis extract in oil (Lindioil) improved nail thickening and onycholysis better than topical calcipotriol.

To prevent nail psoriasis flares, consider trying these tips:

Keep your nails short to avoid injury or lifting of the nail from its bed. Trimming your nails regularly will also help prevent buildup from collecting underneath them.
Avoid biting or picking at your nails and pushing back your cuticles. Injuries to the skin can set off psoriasis flares. This is called the Koebner phenomenon.
Wear gloves when gardening, washing dishes, or doing any kind of work in water. For the best protection, wear cotton gloves under vinyl or nitrile gloves.
Keep your nails clean and dry to prevent infection.
Use a moisturizing cream on your nails and cuticles. This can help prevent cracked or brittle nails.
Avoid cleaning your nails with a nail brush or sharp object. This will help prevent nail separation.
If you smoke, try to quit. Smoking can increase the risk of psoriasis
If you drink, try to do so in moderation, as alcohol is also associated with a higher risk of psoriasis.

If you feel self-conscious about your nails, you can alter their appearance by gently filing and buffing them and by applying polish.

Avoid fake nails, which increase the risk of your nail separating from its bed.

Your symptoms are getting worse or are bothering you.
The treatment you’re using isn’t helping.
You want to try a new therapy or alternative remedy.

A variety of treatments are available for nail psoriasis, and the right one for you will depend on a few factors, including the severity of your condition.

Effective treatment of nail psoriasis in the PsorMak clinic in Moscow

PsorMak clinic offers effective treatments for nail psoriasis. With us you will be able to undergo a comprehensive examination and receive professional assistance.

Make an appointment

Violation of the nail plate is one of the manifestations of psoriasis. It can occur both against the background of systemic skin changes, and independently. External disorders are manifested by damage to the nail, a change in its color, the appearance of seals and deformations. Treatment of nail psoriasis requires complex actions and experience. Clinic “PsorMak” offers effective methods of dealing with the disease.

Reasons for violation

It is important to note that the pathology is not contagious, since it does not have an infectious nature. According to scientists, the most significant factor in the occurrence of pathology is genetics. According to statistics, almost 40% of people with psoriasis are related to people with a similar disease. Geneticists warn that if both parents have psoriatic disorders, then there is a 70% chance that the child will also inherit them. Psoriasis is a multicultural and multiracial disease and is equally likely to affect both men and women. Other causes of nail psoriasis are immune disorders.

Symptoms

The disease is autoimmune in nature. Patients have increased growth and rapid proliferation of epithelial cells, including keratinized ones. The enormous rate of formation of new cells leads to characteristic growths, thickening, layering and other deformations, which have become a characteristic manifestation of psoriasis on the nails.

Cross lines. In medicine, they are known as Beau Reil’s furrows.
Stearin stains or oil stain symptom. Deformation is a change in the color of part of the nail. It looks like a frozen drop of blood.
Subungual hyperkeratosis. Thickening of the skin under the surface of the nail is an important sign in the diagnosis of nail psoriasis.
Leukonychia. Characteristic white dots on the nail plate.
Wavy nail plate.
Onycholysis. Destruction of the nail plate, its softness, brittleness, layering.
Changing the color of the arched area of the nail. With pathology, it acquires a red tint, which indicates an overload of capillaries.

Before treatment, the doctor conducts a series of diagnostic tests. An analysis for psoriasis of the nails is a mandatory procedure in order to exclude a fungal infection and correctly prescribe treatment.

Nail psoriasis therapy

The disease brings significant inconvenience, makes patients complex, reduces self-esteem. A timely visit to the doctor will help minimize the manifestations of psoriasis and put the nails in order.

It is important to understand that there is no single treatment algorithm for all patients. In each case, the doctor selects the method of therapy individually.

Treatment for nail psoriasis includes the following procedures.

The use of healing non-hormonal ointments made according to the recipes of Mack VF from herbal and other natural ingredients.
Topical treatment. For minor disorders, the doctor may prescribe retinoids (preparations containing vitamin A derivatives), antimetabolic drugs, and agents that help strengthen the nail plate.
Removal of the nail with a large area of damage, the procedure is carried out chemically or surgically (in the first case, a special ointment is applied, which leads to rejection of the nail).
Acupuncture, aimed not only at the direct fight against psoriasis, but also at the general improvement of the body.
Psychotherapy to restore the patient’s normal emotional background.
If a fungal infection is detected, fungicides are used.

Your nails will be beautiful and healthy

PsorMak is a clinic for the treatment of nail psoriasis with many years of experience in successful therapy. After treatment with us, patients note long periods of remission and a significant improvement in the nail plate.

Why you should contact the PsorMak Institute:

Effective treatment. Subject to the careful implementation of all medical recommendations, it is possible to achieve a stable remission of psoriasis for a period of six months to six years.
More than 20 years of experience in the treatment of skin diseases. Thanks to the author’s methods of Academician V. F. Mack, hundreds of patients were successfully cured of many dermatological diseases.
No need to go to the hospital. All therapeutic schemes of the Healthy Skin Institute are designed for outpatient use, which allows patients to maintain a normal rhythm of life during treatment.
Affordable price. Due to the affordable pricing policy, patients with a wide variety of budgets are treated at the PsorMak clinic.
Safe therapies. The treatment of skin diseases in the PsorMak clinic is carried out without the use of “heavy” hormonal drugs and other medicines that can harm the health of patients.
Individual approach. Our doctors select the most effective therapeutic regimen for each patient, taking into account his age, duration of the disease and the characteristics of the organism.

Our specialists will accompany you at all stages of treatment, help you overcome the disease and restore the attractive appearance of your nails. You can make an appointment for a consultation by phone or through the online form.

HOW TO BOOK AN APPOINTMENT at the PsorMak Healthy Skin Institute

1. Press the button you see below –

Make an appointment

2. Fill in the fields in the form that appears. Be sure to check the correctness of the phone number so that our specialist can reach you. Once completed, click the “Submit” button.

3. Wait for a call from our specialist. He will answer any of your questions and agree on the date and time of your visit to PsorMak.

The initial appointment includes:

Visual examination , which will allow the specialist to get a general idea of the condition of your skin and the pathology itself.
History taking — finding out information about the development of the disease, living conditions, previous diseases, operations, injuries, chronic pathologies, allergic reactions, heredity, etc. Together with a general examination, this allows you to accurately diagnose and choose a method of treatment and / or prevention.

WHAT HAPPENS after the initial appointment

Our specialist, dermatologist:

Inspect .
Will take a free analysis (scraping) .
Diagnose or clarify the diagnosis of the disease .
Gives detailed advice .
Create a personalized treatment plan .
Write a prescription for drugs (if needed) .

Book an initial appointment

Reviews

Problem: Skin lesions on the palms, feet – psoriasis.
Attending physician: Mak V.F.
Treatment received: ointment.

For 2.5 months treatment with ointment everything went away, healed both on the palms and on the leg. Thank you very much Vladimir Fedorovich, I will advise the clinic to my friends.

Semenova E.V.
(Skin lesions on the palms, feet)

Diagnosis: Psoriasis
Doctor: Mak V.F.
I am very grateful to the doctors of the clinic for their help in the treatment of psoriasis. Nobody could help me. After the treatment, the skin completely cleared up. The remission lasted 6 years. At the moment, I again turned to the clinic, because I am sure that here they will help me in the treatment of psoriasis.

Kuzhnenkova Raisa
(Treatment of psoriasis)

Diagnosis: Psoriasis
Doctor: Mak V.F.
1 time visited by V.F. in 2002. This visit is my second, V.F. gave me hope! It gave me the opportunity to live a fulfilling life. Thank you very much Vladimir Fedorovich!

Naumova Adelya
(Treatment of psoriasis)

Diagnosis: Psoriasis
Doctor: Mak V.F.
Thank you very much doctor! I have been sick for over 12 years and nothing has helped. Psoriasis is gone, there are no plaques, I’m in shock! For 2 months of treatment. Thank you very much, I will recommend you!

Kuzmina Ekaterina
(Treatment of psoriasis)

Diagnosis: Psoriasis
Doctor: Mak V. F.
Dear Vladimir Fedorovich, about 20 years ago I came to you completely tormented by psoriasis, but from the first appointment I began to revive and I am still alive. Further meetings only corrected and meetings were always pleasant. Galina Alexandrovna and I wish you, the whole family and the environment good health.

Askinazi A.E.
(Psoriasis treatment)

Diagnosis: Psoriasis
Doctor: Mak V.F.
Huge human thanks! I have been suffering from psoriasis for 30 years. 20 years since I went to the doctor for treatment. For the first time there was an improvement and a long remission. This is the only treatment I trust.

Grudina T.N.
(Treatment of psoriasis)

Diagnosis: Psoriasis
Doctor: Mak V.F.
Thank you for the treatment. We suffered for many years with this problem, and only they helped us.

Tukhtasinova K.B.
(Psoriasis)

Diagnosis: Psoriasis
Doctor: Mak V. F.
Clinic prescription ointment used. Just wonderful. Contacted in June 2016. and after all the tests, I began to treat the affected areas with ointment (the palms were just in a terrible state) and after 8-10 months there was an improvement and now it’s just good. Thank you!!

Inshakov V.I.
(Moderate psoriasis)

No pain, fast and not scary. Thank you very much for the positive reception and for the quality removal!!!

Tancheva A.M.
(Skin neoplasm)

The best impressions from communication and the procedure for removing neoplasms with Dr. Gribanov N.V. The professional and sensitive approach to the patient exceeded all expectations.

Makhnach T.
(Skin neoplasm, dermatitis)

Our doctors Academician of RAMTS

Kristina Vladislavovna Sprogis

Dermatovenereologist

Zakhar Petrovich Malinov

Reflexologist, psychotherapist

Viktor Vladimirovich Mak

Dermatovenereologist, PhD .

Results of treatment

Psoriasis of smooth folds

Treatment of psoriasis of hands and nails

Treatment of psoriasis of the hands and nails

Treatment of psoriasis of the head

Treatment of psoriasis of the scalp, psoriasis of the elbows

Treatment of psoriasis of the scalp, psoriasis of the lobe tei

Treatment of perioral dermatitis

Treatment hand eczema

Hand eczema treatment

Atopic dermatitis treatment

Treatment of psoriasis

Publications

How sea water helps with psoriasis. Like swimming in the sea and…

how to put your nails in order?

Nail psoriasis is a manifestation of psoriasis, a chronic skin pathology of a non-infectious nature.

The essence of the disease is that the cells of the upper layer of the skin divide, grow and die at a rate 5 times higher than normal. This leads to the accumulation of excess cells on the skin.

There is local inflammation, the formation of scaly red or gray-white spots, ulcers, blisters. In 60% of patients, damage occurs not only to the skin, but also to the nails. Rarely, the disease manifests itself on the nails without affecting other parts of the body. More common in men than in women.

What is psoriasis?

Psoriasis is a chronic inflammatory skin disease. According to the mechanism of development, it belongs to autoimmune pathologies and metabolic disorders. Outwardly, it manifests itself in the form of characteristic formations on the skin, which are called psoriatic plaques.

Peculiarities of the rash: peeling, scaly, dry surface, rich pink-red color. The elements of the rash merge with each other, forming large plaques that rise above the skin.

The reason for the formation of plaques in the excessive growth of epidermal cells of keratinocytes, the accumulation of cells of the immune system of lymphocytes and macrophages in the area of inflammation. In addition, active angiogenesis or the formation of new capillaries occurs, which causes a red color.

Psoriatic rash appears on the body only during exacerbations of psoriasis, and during remission it is absent or slightly expressed. Causes intense itching and pain. The rash can occur anywhere on the body, but is more common in areas that are subject to friction or pressure. This is the scalp, elbows, hands, knees, buttocks. The disease gives a person severe discomfort both from a physical and moral point of view. After all, such rashes are difficult to hide under clothing or disguise.

Despite the repulsive and frightening appearance of the rash, psoriasis is not dangerous to others. The disease is non-infectious and non-contagious.

Nail psoriasis affects 60% of people. Moreover, the mechanism for the appearance of changes is the same as on the skin. Under the nails, on the skin of the bed or around the nails on the surface, psoriatic plaques form.

What causes?

The main risk factor for the development of psoriasis is hereditary disposition. In 40% of patients, the next of kin suffer from the same disease.

Other causes that provoke psoriasis of the nails of the feet and hands include:

nervous stress, emotional instability;
living in a cool, dry climate;
past infectious diseases;
bad habits;
malnutrition;
frequent mechanical damage to the nail plate.

Nail psoriasis is a chronic disease that has not yet been cured.

It consists of periods of remissions and exacerbations. Exacerbation attacks are caused by some drugs (lithium preparations, antidepressants, antimalarials, anticonvulsants, antibiotics), dietary errors, alcohol intake, nervous stress, infections.

The risk of developing the disease does not depend on sex or age. Nail psoriasis in a child is not uncommon, and even a newborn can suffer. The first signs of pathology in childhood in 75% of cases are detected by parents or doctors before the age of 5 years.

What does nail psoriasis look like?

Symptoms of the disease are varied. Nail damage characteristic of psoriasis affects the matrix (growth zone), nail bed tissues, and lateral ridges. Such changes are called psoriatic nail dystrophy. Depending on the severity and location of the focus of inflammation, it manifests itself in the form of different conditions.

Damage to the nail matrix causes thimble syndrome, leukonychia, plate dystrophy, onychorrhexis, transverse furrows (Beau’s lines). If the nail bed is involved in the inflammatory process, then this manifests itself in the form of onycholysis, hyperkeratosis, fragmental hemorrhages, spots. The defeat of the rollers leads to psoriatic paronychia. Each of these types of dystrophy is observed individually or in combination with others.

Some nail changes are painful, making it difficult to move the fingers freely. Examples of psoriasis of the nails of the hands in the photo (on the legs, the manifestations look similar):

More options for dystrophy are described below.

Thimble Syndrome

Thimble Syndrome is the most characteristic and striking symptom of nail psoriasis. It is he who occurs more often than other manifestations of pathology on the nails. The longer a person is sick and the more severe the form of the disease, the higher the risk that this symptom will appear. Thimble syndrome – these are depressions scattered over the entire surface of the nail plate. Their diameter is from 1 to 1. 5 mm. These depressions line up in lines, rows, or are random.

The reason for the appearance of depressions is associated with the formation of small psoriatic papules in the area of the matrix, where new plate cells are born. Papules create obstacles for the formation of a smooth structure of the nail, disrupt the structure of the plate. The upper layer of nail cells does not keratinize correctly everywhere, some of the cells subsequently exfoliate, resulting in the formation of depressions.

In addition to psoriasis of the nails, such changes in the structure of the plate are observed in alopecia, eczema, dermatitis and other pathologies. But with psoriasis, they are deeper and quite painful when pressed.

Furrows

In psoriasis, the nail plate is covered with transverse furrows, which are also called Bo’s lines or furrows. These are deep transverse notches that form against the background of psoriatic inflammation in the area of the nail matrix. Inflammation interferes with the normal growth of the nail, disrupts the compactness of the stacking of the cells of the nail plate. Depending on the width of Bo’s lines, it is easy to guess how long the inflammation has been.

Beau’s lines are not characteristic signs of nail psoriasis. They are also observed in other conditions. For example, with injuries, circulatory disorders, infections, malnutrition.

Onycholysis

Onycholysis is detachment of the plate from the nail bed. It usually occurs gradually, without pain or inflammation. More often, separation of the plate is observed from the side of the free edge or on the sides. The onycholysis zone can be of different shapes: circle, crescent, longitudinal stripes. The main cause of onycholysis is a violation of the adhesion or adhesion between the cells of the plate and the bed. As a result, a subungual space is formed, where air bubbles, dust, particles of the epidermis penetrate. Due to the ingress of air, the onycholysis zone looks white, grayish-white or yellow-white.

Detachment of the nail in psoriasis provokes a violation of the formation of the layers of the plate against the background of inflammation. Onycholysis is also found in metabolic disorders, diabetes, vitamin deficiency, allergies, and weakened immunity. But the peculiarity of psoriatic onycholysis is the presence of a narrow light pink stripe outlining the zone of detachment. Over time, this band becomes yellow or brown.

Rarely in psoriasis, the nail exfoliates not from the side of the free edge, but from the side of the lower ridge or growth zone of the nail. This is called onychomadesis. Unlike onycholysis, onychomadesis develops rapidly and is characterized by a severe course.

Subungual hemorrhages

Subungual hemorrhages in psoriasis resemble splinters or splinters. These are small black, yellowish-brown or brown-black vertical lines. They are formed by rupture of the capillaries that permeate the nail bed. The rupture occurs at the slightest injury to the plate due to overflow of small vessels in the area of psoriatic plaques.

Similar vertical lines still form with subungual melanoma and infective endocarditis, so see your doctor to find out why.

Subungual hyperkeratosis

Subungual hyperkeratosis is a thickening, increase in the size of the hyponychium or the visible part of the nail bed, which adheres to the plate from the side of the free edge. Thickening occurs due to the growth of hyponychial cells as a protective reaction in response to chronic local inflammation.

In case of subungual hyperkeratosis, gray-yellow horny masses accumulate under the plate, which compress the soft tissues of the nail bed, cause inconvenience and pain.

Subungual hyperkeratosis is often present in fungal nail infections and it is important to distinguish it from psoriasis.

Psoriatic paronychia

Paronychia is an inflammation of the skin on the nail folds. With psoriasis, in addition to inflammation, there is a thickening of the skin, redness of the fingertips. Often there is an accumulation of pus with its subsequent release from under the nail roller.

Spots on the nail plate

With psoriasis, spots of various shapes, sizes and colors form on the nails. White, yellow, red in color.

The characteristic signs of the disease include a translucent “oily” or “salmon” spot. It looks like a drop of blood frozen under the plate. This is how a psoriatic plaque formed under the plate looks like.

White spots on the nails are called leukonychia. They are in the form of stripes or small dots. Formed due to the ingress of air bubbles between the plate and the bed. In this place, the nail loses its transparency, and the surface becomes white. The reasons for their appearance are numerous, but psoriasis is included in this list.

Red spots are formed due to the expansion of capillaries in the area of the nail bed.

Differences from other pathologies

Symptoms of nail psoriasis are observed in other nail problems. But people with psoriasis tend to have skin manifestations of the disease, so it is enough to carefully examine the body. If psoriatic changes are present only on the nail plate, the diagnosis becomes more complicated. It is important to find out from the patient whether the parents had this disease. If necessary, to clarify the diagnosis, the doctor will prescribe a biopsy of the nail bed, examine the skin with a dermatoscope, and take a scraping from the changed part of the plate to identify fungal pathogens.

In the absence of skin manifestations, psoriasis is difficult to distinguish from a fungal nail infection (onychomycosis). External symptoms are similar: onycholysis, turbidity, thickening, destruction of the nail plate. It is possible to find out a fungus or psoriasis on the nails after a mycological examination of a scraping from the affected part. With onychomycosis, fungi will be found. In 35% of cases, both diseases are present simultaneously. Inflammation, which is with psoriasis, facilitates the penetration and reproduction of pathogenic pathogens. With the addition of a mycotic infection, the symptoms of nail psoriasis will intensify.

Psoriasis is often confused with another similar skin disease, eczema, which also affects not only the skin but also the nails.

How to distinguish between nail psoriasis and eczema? Look for skin rashes. With eczema, watery vesicles are formed, the elements of the rash are weeping, later covered with crusts. Eczema appears only on sensitive areas of the skin, on the inner flexion surfaces of the knee and elbow joints. With psoriasis, rashes can be anywhere on the body.

How to treat nail psoriasis?

Psoriatic changes make nails look frightening. This causes feelings, fears, complexes, especially in women. I want to hide and not show my hands to anyone, it’s embarrassing to go outside the house, constantly feel embarrassed. Surrounding people immediately believe that this is something infectious, instinctively step aside. Although in fact the disease is not contagious, it is not transmitted from one person to another even through close contact.

Nail psoriasis causes serious psychosocial and cosmetic problems. Therefore, the main task of treatment is to improve the appearance of the hands. It takes time to notice positive changes. This is due to the slow growth of the nail plate, the cumulative effect of the drugs used.

Systemic and local agents are used as medicines. For each person, the doctor selects them individually, taking into account the symptoms, the severity of the condition. Sometimes you have to try different treatment regimens in order to achieve a result. Reviews on nail psoriasis forums from patients confirm this fact.

In addition to drugs, a course of phototherapy or insolation is sometimes prescribed. Impact on the affected areas of the skin and nails helps to stop excessive cell division and plaque formation, relieve inflammation, itching.

In case of severe damage, when restoration of the nail plate is impossible, it is removed. Subsequent therapy is directed to the growth of a new healthy nail. Vitamins help speed up growth. They are prescribed internally and externally in the form of oily solutions (Aevit) for treating the skin of the finger, the nail bed, and the growing plate.

Any medications are used only under the supervision of a dermatologist, carefully following the instructions of the doctor. Self-treatment of psoriasis can exacerbate the disease, prolong the course of therapy, and create serious complications.

Systemic drugs

Systemic drugs, if necessary, prescribed by a dermatologist.

These are the same remedies that are used for psoriatic skin rashes:

Cyclosporine. Refers to immunosuppressants or drugs that suppress the activity of the immune system. Stops the formation of new psoriatic plaques and reduces the size of existing ones. It is mainly used only for severe forms of psoriasis;
Methotrexate. Affects the metabolism inside cells, blocks the vitamin activity of folic acid. In psoriasis, it exhibits an immunosuppressive effect, suppressing the pathological autoimmune reaction;
Retinoids. These are synthetic analogs of vitamin A that affect immune cells, normalize the reproduction and development of keratinocytes. Suitable for long term use
Wobenzym. An enzyme preparation that helps to remove the unpleasant symptoms of psoriasis during exacerbation. Removes inflammation, swelling. It has a general strengthening effect, prevents relapses and further deterioration.

Self-medication with the listed drugs is unacceptable, as there are contraindications, dangerous side effects.

Local funds

Of the local remedies for nail psoriasis, they are prescribed:

Ointments based on medical grease (Kartalin, Magnipsor, grease ointment). They have an anti-inflammatory, regenerating, exfoliating effect;
Hormonal ointments with corticosteroids. They are first-line drugs for symptomatic relief. Relieve inflammation, pain, redness. Improve the condition of the nail bed and matrix;
Creams Calcipotriol, Daivonex. They contain a synthetic analogue of vitamin D. They regulate immune processes in the skin, slow down the accelerated division of cells in the stratum corneum. Especially effective in subungual hyperkeratosis;
Ointments with retinoids (Zorak, Tazaroten). Exfoliate inflamed, damaged cells of the epidermis, smooth the surface of the skin. Help with psoriatic dystrophy affecting the nail bed and matrix, but the therapeutic effect develops slowly;
Keratolytic varnishes, gels with urea. Exfoliate, smooth the surface of the nail plate, nourish.

Folk remedies

Also folk remedies are used to treat nail psoriasis at home. By agreement with the doctor, they are used as an addition to the main drugs.

Baths, compresses, lotions with decoctions of medicinal herbs that have antiseptic and healing effects help. These include bay leaf, sage, oak bark, chamomile, celandine.

Rules of care

Daily care at home increases the effectiveness of the prescribed treatment, reduces the frequency of exacerbations.

For this you need:

protect nails from injury;
keep hands and feet dry and clean;
cut nails short, file the edges with a nail file for smoothness;
disinfect manicure instruments;
do not remove the cuticle;
wear protective gloves when washing dishes, working with household chemicals, in the garden;
daily moisturize the skin of the hands and feet with cream;
do not apply gel polish, do not use decorative varnishes.

In addition to proper care, it is important to rethink your lifestyle. It is recommended to get rid of bad habits, follow a diet.

What kind of diet do you need? It is better to give up alcohol, sweets, fatty, salty, spicy foods, pastries, smoked meats. Preferably steamed, boiled or baked. Also, for the duration of treatment, highly allergenic foods are limited. These are eggs, milk, nuts, chocolate, citrus fruits. The basis of the diet is fresh vegetables, fruits, greens, low-fat varieties of fish and meat, dairy products, whole grain cereals.

If you suspect you have nail psoriasis, don’t worry, your nails can improve. The main thing is to choose the right treatment, care, be regularly observed by specialists, learn to control the disease.

Contact the Podology Center Eva Korneeva, where you will be examined or treated by a dermatologist, podologist, mycologist. We will help you put your hands and feet in order, add self-confidence.

To make an appointment, call +7 (495) 822-30-40 (Moscow).