Nail psoriasis

Nail pso­ria­sis is invol­vement of the fin­ger and toe nails in pso­ria­sis. It occurs in about half of all pati­ents and can rare­ly appear wit­hout skin chan­ges. It is often par­ti­cu­lar­ly distres­sing, as the hands are always visible.

Cau­ses

The pso­ria­tic inflamm­a­ti­on affects the nail matrix and nail bed, dis­tur­bing nail for­ma­ti­on. The basis is the same mis­di­rec­ted immu­ne reac­tion as in skin pso­ria­sis. Mecha­ni­cal strain on the nails can inten­si­fy the changes.

Sym­ptoms

Typi­cal are pin­head-sized pits in the nail pla­te, yel­low-brown oil spots, thi­c­ke­ning and crumbling as well as sepa­ra­ti­on of the nail from the nail bed. The nails can beco­me britt­le and pain­ful. Nail invol­vement is asso­cia­ted with joint com­plaints more often than average.

Tre­at­ment

First a nail fun­gus infec­tion is ruled out, as both pic­tures look simi­lar and often occur tog­e­ther. Topi­cal­ly, vit­amin D ana­lo­gues, cor­ti­cos­te­ro­id pre­pa­ra­ti­ons and spe­cial nail lac­quers are used, some­ti­mes sup­ple­men­ted by injec­tions. In exten­si­ve invol­vement or con­cur­rent joint dise­a­se, sys­te­mic the­ra­pies are effec­ti­ve; pati­ence is nee­ded, as nails grow slowly.

Rela­ted tre­at­ment at Swiss Der­ma Cli­nic: Pso­ria­sis treatment