Nail Psoriasis

Changes in the Fingernails Caused by Psoriasis

The nails are often affected by psoriasis. In fact, 80 to 90% of people with psoriasis will have nail changes at some point in their lives. The fingernails are more often affected than the toenails. Psoriasis can affect all aspects of the nail, causing various abnormalities.

Nail Abnormalities

The following are common abnormalities associated with nail psoriasis:

• Pitting - This is the most frequent nail abnormality with psoriasis. The nail has tiny, punched-out depressions that grow out with the nail.
  
  
• Nail Separation - Psoriasis can cause the nail bed to pull away from the nail itself. The nail plate may turn yellow, resembling a fungal nail infection.
  
  
• Oil Spots - Skin debris and fluid often collects in the spaces caused by nail separation. This results in brownish-yellow spots, hence the fitting name.
  
  
• Nail Deformity - Psoriasis can affect the nail matrix, the area of the finger where the fingernail is made. This can cause the nail to crumble and break easily.

Similar Nail Changes with Other Rashes

Other rashes cause nail changes and may be confused with psoriasis. The following are the most common:

• Eczema
• Fungal infections
• Alopecia areata

_Sources:

De Barker, David. "Diagnosis and management of nail psoriasis." Dermatologic Therpay 15(2002): 165-72.

Habif, Thomas. "Psoriasis." Clinical Dermatology, 4th Edition. Ed. Thomas Habif, MD. New York: Mosby, 2004. 209-39.

van de Kerkhof, Peter. "Psoriasis." Dermatology. Ed. Jean Bolognia. New York: Mosby, 2003: 531-5. 125-37