How to treat toenails affected by psoriasis. Toenail psoriasis: photos and treatment

Nail psoriasis is diagnosed in 7% of patients suffering from skin manifestations of chronic pathology. Inflammation of the epidermis is often accompanied by another unpleasant manifestation.

Damage to the nail plates in this form of severe chronic disease has characteristic symptoms. Nail psoriasis exists not only as a concomitant form, but also as an independent disease. How dangerous is this pathology? Let's figure it out.

Causes

It is known that psoriasis is one of the most “mysterious” diseases. Lesions in various parts of the body, including nails, appear both under the influence of progressive factors and for no apparent reason.

Scientists have found that signs of psoriasis on the nail plates occur with the following phenomena:

disruption of metabolic processes in the body;
infectious diseases;
weakened immunity;
after strong emotional experiences;
frequent, prolonged stress;
hormonal imbalance;
hereditary predisposition.

Important! Psoriatic lesions of the stratum corneum often occur due to vitamin deficiency. Insufficient nutrition, poor in micro- and macroelements, contributes to the growth of the affected area and the severe course of the disease.

First signs and symptoms

Psoriasis of the nail plates has a number of characteristic symptoms. How not to confuse the signs of this chronic disease with manifestations of a fungal infection?

The difference is that some psoriatic nail lesions look distinctive. When pathogenic fungi multiply, such signs are not diagnosed.

A photo of each of these symptoms will help you understand that you have nail psoriasis and not mycosis. If you discover these phenomena, be sure to visit a dermatologist. The lack of timely treatment leads to severe damage to the nails, weakened immunity, and deterioration of the general condition.

Subungual hemorrhages

This term combines two varieties with different symptoms:

first view. Under the stratum corneum, hemorrhages of brown, reddish, sometimes purple-black color, resembling stripes, appear. This symptom occurs after capillary rupture;
second type.“Oil stain syndrome” is difficult to confuse with manifestations of other diseases. Spots of different shapes and sizes are visible under the nails. Color – bright red or pink.

Onycholysis

This symptom occurs in many patients. An unpleasant manifestation in which the split nail plate is separated from the nail bed without pain. With this form, a thin strip of dirty pink color always appears, changing the shade to yellowish-brown over time. There are partial and complete onycholysis.

The process is accompanied by the penetration of dirt, air bubbles, and particles of dead epidermis under the exfoliating stratum corneum. Sometimes an unpleasant odor appears.

Thimble Syndrome

A characteristic symptom of psoriasis of the nails of the fingers and toes is quite common. The formation of the plate is disrupted, the stratum corneum is covered with small pits with a diameter of 0.5–2 mm. The recesses resemble the pits of a thimble and are located chaotically. The shape, color, and size of the formations differ on all fingers.

Note! Pits on the stratum corneum are sometimes found in chronic dermatoses. If this symptom is detected, only a doctor can make an accurate diagnosis by prescribing additional tests.

Trachyonychia

It is less common and is characterized by roughness of the surface of the stratum corneum and dull color of the nail plate. In most cases of trachyonychia there is no lunula at the base.

In some patients, in the early stages, the surface of the nails becomes flat, then more concave. After a while, a depression appears in the central part of the nail.

At this address, read an interesting article about the causes and methods of treating lip jams.

Unfortunately, there is no clear algorithm for preventing this disease. It’s not for nothing that psoriasis is called an “insidious disease.” There are no vaccinations or specific preventive measures that can provide a 100% guarantee of protection against the development of a chronic disease.

What measures help minimize the risk of psoriatic nail lesions? Take note:

strengthen the immune system;
eat right;
take multivitamin complexes;
maintain personal hygiene;
treat microtraumas on the stratum corneum in a timely manner;
In case of severe bruises or damage to the nail plates, be sure to seek medical help;
be less nervous;
monitor the state of the endocrine system;
Treat infectious diseases promptly.

Important! Pay attention to the health of your nails. Lubricate them with nourishing creams, make herbal baths, take calcium supplements. A good effect is achieved by using regular brewer's yeast. This natural product strengthens the stratum corneum, preventing delamination and dryness.

Start treatment for psoriasis of your fingers and toes as early as possible. Follow the recommendations of a dermatologist, be sure to use traditional medicine recipes. Peace of mind and support from loved ones will help you quickly overcome the disease or reduce unpleasant manifestations.

Next video. Find out even more about treatment methods and nail care for psoriasis:

Nail psoriasis turns out to be an unpleasant surprise for most patients. In 93% of cases, onychia serves as an addition to skin rashes, and only in 7% of cases it develops in isolation, without skin symptoms. Nail psoriasis should be treated by the same doctor as psoriatic plaques on the skin, namely a competent dermatologist who is up to date with modern pharmacological innovations.

General and specific symptoms

When faced with psoriatic onychia for the first time, patients make the false conclusion that they are sick with a fungus. Indeed, the picture is similar:

the plate delaminates and crumbles;
the nail loses elasticity and becomes brittle, pieces break off;
the color changes to a cloudy yellowish-brown or opaque white;
voids form under the nail;
the plate loses its glossy shine, becomes dull and matte;
the surface of the nail becomes prominent, in some it becomes covered with bumps and folds;
depressed marks appear, similar to needle pricks;
the cuticle becomes dry, many painful hangnails appear

These symptoms are not specific and may indicate mycosis or thyroid disease. The distinctive features of psoriatic lesions are:

pinpoint hemorrhages under the nail plate;
hemorrhages in the form of longitudinal or transverse stripes;
oval and round hemorrhages visible through the nail.

The color of the hemorrhage is at first bright scarlet, and then it fades into darker and more saturated colors: crimson, bluish-red, red-brown. Hemorrhages can pass and occur spontaneously, but at a severe stage of the disease their constant presence is noted.

Advice! In order not to guess from what exact disease the fingernails or toenails have suffered, you need to turn to laboratory diagnostics. Any dermatologist can provide a referral for testing.

Treating nail psoriasis with antifungal varnishes is completely useless. Unfortunately, this is exactly what patients do instead of visiting a dermatologist and having psoriasis diagnosed. What will delay or incorrect therapy lead to:

the plate will be significantly destroyed and lose its attractive appearance;
the growth area will be affected;
the nail will fall off.

No more than 1% of all victims experience complete loss of nails, however, this result will inevitably be obtained by anyone who avoids treatment for 5 years or more. The speed at which onychia progresses varies from person to person; according to statistics, delayed-type lesions are more common. If the pathology develops smoothly, you can lose a nail after 10 years or more, and if it develops suddenly, within a year.

What is needed for an accurate diagnosis:

visit a dermatologist;
make a scraping from the plate;
wait for the results from the laboratory.

Attention! Psoriasis is not transmitted from person to person, unlike fungus. If 2 or more people in a family become ill at the same time, then we are definitely not talking about onychia.

The type of psoriatic lesion is of great importance for diagnosis or self-diagnosis, and not for therapy. The course of treatment will be the same in all cases. In dermatology, there are 4 types of psoriatic lesions, and these types have the following features:

Paronychia. Comes with advanced pustular psoriasis or occurs simultaneously with erythroderma. In extremely rare cases (less than 1%), it develops independently, without skin symptoms. With paronychia, the skin around the nail becomes swollen, thickened, and red. The inflammatory process proceeds rapidly, the patient complains of throbbing pain and subjectively feels an increase in temperature throughout the finger. Infiltration covers not one, but all phalanges, and can even spread to the palm. A large amount of pus is released from the inflamed periungual fold, the nail actively peels off and may fall off. The process occurs with intense pain.
Onychomadesis. The main feature of this type of onychia is the rapid and painless loss of the nail. In this case, there may be itching or discomfort in the area of the periungual fold. Hemorrhages are either absent or minor.
Trachyonychia. Not such a severe type of onychia, in which the finger simply becomes aesthetically unattractive. The hole near the growth zone disappears, the plate becomes concave, becomes thick, brittle and cloudy. Dermatologists call this type of onychia “spoon-shaped nails,” because if you pour a drop of water on such a nail, it will not roll off, but will linger on it, like in a spoon. The pathological process rarely affects the soft tissue under the nail plate; nail loss occurs no more often than in 0.5% of cases.
Onycholysis. With onycholysis, inflammation is sluggish and sometimes may be completely absent. The nail is whitish, dirty yellow or brown, in all cases opaque. As a rule, cracking begins from the edge, in rare cases from the center of the plate. Vast voids form under the plate, in which particles of dead skin accumulate. When cutting the nail, the dry and non-elastic plate crumbles. Psoriasis of this type differs from all others by the presence of a bright pink stripe bordering the area of psoriatic damage from healthy tissue.

Those patients who responsibly follow the instructions of a competent dermatologist can delay the progression of the disease and avoid nail loss.

Instructions: how to get rid of nail psoriasis

In more than 95% of cases, the patient can significantly improve their condition without hospitalization, at home. Indications for hospitalization are erythroderma or an active inflammatory process in which swelling and hyperemia spread to the entire phalanx of the finger. For competent therapy you need only 5 components:

Consider onychia in the context of the general course of psoriasis, and not in isolation. Nail psoriasis will stabilize and go into remission when the autoimmune inflammatory process of a systemic nature subsides.
Select preparations that are suitable specifically for treating the plate, and at the same time use regular medicinal body cosmetics. Nail psoriasis in mild cases is treated with local remedies (in the form of varnish), in severe cases - with systemic drugs (tablets, injections).
Eliminate the influence of food and contact allergens. This is a prerequisite for long-term remission. Allergy skin testing is contraindicated in psoriasis, but venous blood testing can be done. Then you need to take any classic diet for psoriasis (for example, Pegano’s original development) and adjust it to your needs.
To clarify the clinical picture, it is useful to do a biochemical blood test and exclude pathologies from the endocrine system. Information about existing hormonal disorders will greatly help the dermatologist.
Detoxify regularly using a cleansing diet, drinking plenty of mineral water or the Kondakova method.

Another prerequisite for remission is thoughtful care for your toes and hands. Recommendations given by dermatologists:

cut the nail short every 2-4 days;
do not do a manicure, do not trim the cuticle, do not file the edge of the plate;
do not dig out dirt and skin particles from the voids under the plate;
protect the surrounding skin from dyshidrosis, moisturize with cream every time after taking a shower.

Treatment of fingernail psoriasis will be successful provided that the patient:

always wears gloves when washing dishes, working around the house or in the garden;
does not use decorative nail polishes;
does not whiten the nail;
does not wear false nails or shellac;
moisturizes hands every time itching and dryness appear;
uses only specialized cream for psoriatics.

Toenail psoriasis requires the following conditions for recovery:

refuse tight shoes;
do not wear synthetic socks;
do not allow your feet to irritate and sweat;
use open or breathable shoes;
do not walk around the house in sweaty and old slippers, use rubber slippers.

Flip-flops should be thoroughly washed once a week or more often. Psoriatic lesions do not protect the nail from fungal infection, but, on the contrary, reduce local immunity and contribute to the development of mycosis.

Fact! 5% of victims of nail psoriasis also have a fungus. The fungal infection needs to be treated first.

How to treat?

At home, you can use more than 40 different recipes to improve the health of nails with psoriasis. Here are 5 popular ones:

Tar compresses. High-quality and purified birch tar is suitable for this. Keep the compress for no more than 30 minutes.
Baths with medicinal plants. You can use chamomile, calendula or any antiseptic mixture, even celandine. It is advisable to end the baths with a contrast shower to stimulate microcirculation.
Ointments with grease and pure grease. Products such as Magnitopsor or Antipsor are applied not only to the nail, but also to the entire periungual fold. You can also use: Kartalin, Picladol, Psorialam, Psorium, Psorikrem and just grease.
Naftalan mud. Sold in pharmacies, it is essentially a petroleum product, which, due to its toxic effects, slows down the division of skin and nail cells.
Irradiation with a UV lamp. First, you should try the procedure in a clinic, and then you can buy a device and treat your nails at home.

To slow down the destruction of the nail plate, you should always cover the nail with ordinary or vitamin transparent varnish. The varnish should be washed off with products without acetone. There should be no nail polish on the nail while using medicinal compresses or ointments.

Dermatologists wish recovery to everyone who suffers from nail psoriasis; it is never too late to see a doctor.

Nail psoriasis (psoriatic onychodystrophy) is a type of manifestation of a chronic skin disease of a non-infectious nature, often the beginning of a general lesion of the skin.

The nature of the disease is autoimmune and consists of excessive proliferation of cells of the immune system and skin keratinocytes, as well as excessive formation of small tissue capillaries around the nail. Usually, psoriatic plaques or other nail lesions are detected even before symptoms of the disease appear on the head and body.

In other cases, psoriasis on the nails can exist as an independent disease.

Photo of nail psoriasis

Causes of psoriasis on nails

The main cause of psoriasis on the fingernails and toenails is a malfunction in the immune system, which disrupts the processes of fermentation of substances and cell formation. Improper formation of the body's immune response leads to the release, division and growth of immature cells of the epidermis and the stratum corneum of the nail plate.

Since the body perceives such cells as foreign aggressors, leukocytes and lymphocytes are mobilized around the inflamed areas in large quantities, which leads to the development of an inflammatory process in certain areas of the skin. The production of specific antibodies causes the development of damage to one's own skin and nails.

Another most important factor- burdened heredity. There are genes that predispose to the development of psoriasis. Some factors can trigger the development of the disease at any age:

Cold, dry weather. Such weather conditions are often the impetus for the first manifestation of psoriasis, as well as the occurrence of its relapses.
Severe and prolonged stress.
Untreated bacterial and viral infections, for example, streptococcal (pharyngitis, tonsillitis), human papillomavirus, and HIV infection.
Skin injuries - abrasions, cuts, scratches.
Taking certain medications - beta blockers, lithium-containing medications, chloroquine, blood pressure medications, non-steroidal anti-inflammatory drugs, medications containing female sex hormones.

Given a combination of several unfavorable factors, the risk group for the incidence of nail psoriasis is young people under 20 years of age, most often males, as well as elderly people of both sexes.

Symptoms and signs of psoriasis on the nails

The symptoms of the disease are varied and depend on its type and form. The main, most common signs of nail psoriasis:

Pinpoint depressions, grooves, dents on the surface of the nail.
Changes in the color of the nail plate, acquisition of gray, brown, yellow shades, dullness, susceptibility to breaks, crumbling.
An inflammatory border along the edge of the affected nail, involvement of fingers and toes by manifestations of psoriasis, severe peeling of the skin.
Psoriatic plaques on the surface of the nail, yellow spots similar to oil, loosening, peeling of the nail.
Formation of deep holes on the nail bed after its detachment.
Transillumination of capillaries, bruises through the nail plate.
Dryness of the nails and the skin around them, the formation of convex growths, humps, subungual growth of connective tissue, purulent discharge from under the nail.
Itching of the skin, areas around the nails, toes and hands. May vary from strong to absent.

Types and types of psoriasis on nails

The clinical picture of psoriatic manifestations on the fingernails and toenails is very diverse. Depending on the external symptoms, there are several types of nail psoriasis:

Thimble psoriasis. It is considered the most common, “classical” form of the disease. It is expressed in the appearance of small pits on the surface of the nail plate in the form of a scattering of dots.

Onycholysis. In this case, the nail plate is separated from the tissues of the bed, and no inflammation or pain is observed. A distinctive feature is a pink or yellow psoriatic border around the separated nail. In turn, this type of nail psoriasis can be divided into kinds:

according to the extent of the process - complete or partial;
in the direction of separation of the nail from the bed - central, lateral, distal.

Onychomadesis. Like onycholysis, it manifests itself in the form of separation of the nail plate from the bed, but differs in that the process occurs quickly, and there is no border around the nail. It is considered a severe type of nail psoriasis, difficult to treat.

Subungual hemorrhages(hemorrhages). Take place in two different manifestations:

pink, red spots, veins of different sizes and shapes visible through the nail plate;
the veins under the nail plate acquire a brown or black tint and a stripe-like shape, which is associated with ruptures of larger capillaries.

Trachyonychia. With this form of psoriasis on the nails, their surface becomes rough, uneven, rough. A variation of the type - koilonychia - is complemented by a flattening of the nail plate, and subsequently by a bending of its edges upward.

Psoriatic paronychia. It is more common in generalized forms of psoriasis. The skin around the nail and nail folds become very inflamed and thickened. Hyperemia can spread to the entire finger.

Stages of development of psoriasis on the nails

The course of the disease includes several stages, during which the nail acquires the main psoriatic signs:

First stage– darkening, clouding of the nail plate. The appearance of small longitudinal and transverse stripes, depressions, sometimes forming a mesh.
Second stage– thickening of the nail, as well as changes in the color and consistency of the nail. The shade becomes gray, brown, yellowish. In the hemorrhagic form of the disease, blood streaks appear under the nail plate. Purulent discharge from the nail fold is not uncommon.
Third stage– separation of the nail from the tissues of the finger or toe. Often accompanied by the addition of a fungal or bacterial infection. It is considered an advanced form of the disease, reflecting nail atrophy. Before the plate peels off, “oil spots” may appear - yellow-brown formations that resemble an oil stain, as well as psoriatic plaques.

Consequences of nail psoriasis

Psoriasis is considered an incurable disease. It is capable of relapses throughout the patient’s life, even after a long lull. Despite the fact that the disease does not pose any threat to others, for the patient himself, any form of psoriasis can significantly increase the risk of developing cardiovascular diseases, especially heart attack.

Nail psoriasis, usually foreshadowing common forms, aggravates the course of atherosclerosis of the arteries and any inflammatory processes.

The emotional, psychological and social consequences of the disease can also be severe. Neuroses, depression, alcoholism are conditions that accompany most patients with psoriasis. In the case of a severe mental state, the risk of heart disease, diabetes, and cancer increases significantly. Against the background of the development of psoriasis, the course of other chronic conditions and diseases is often aggravated.

Nail psoriasis can deform the nail plate to the point of deformity and the inability to appear in public places. Severe forms of this type of disease can cause a constant increase in body temperature, weakness, and impaired absorption of folic acid by the body. Generalized forms of psoriasis, affecting both the fingernails and toenails, can cause the development of a serious disease - Zumbusch psoriasis, which requires hospitalization and has a certain mortality rate.

Diagnosis of psoriasis on the nails

Typically, diagnosis of the disease is based on an external examination, since changes in the composition of blood parameters (leukocytosis, acceleration of ESR) are observed only in severe forms of the disease. To clarify the diagnosis, it is recommended to perform a biopsy of the damaged area of skin around the nail or psoriatic plaque that has formed on the nail plate.

Basic principle of diagnosis– differentiation of psoriasis from other skin diseases:

The difference between nail psoriasis and paronychia and onychia of fungal and bacterial origin, as well as nail dystrophy in other dermatological diseases. To do this, all the main signs inherent in psoriasis of the nail plate are diagnosed.
Differentiation of psoriasis from candidal paronychia by signs: release of purulent contents, spread to all nails of the toes or hands.

Treatment of psoriasis on nails

Therapy for the disease is long-term and is based on a comprehensive approach. All existing methods of treating psoriasis are selected by the doctor based on the clinical picture, the severity of the disease and the tendency to relapse, as well as individual tolerance and the presence of concomitant diseases. At the initial and middle stages of the disease, treatment begins with the use of local drugs:

Ointments, creams containing corticosteroids. They are the main group of drugs against nail psoriasis. At the initial stage of the disease, triacort, triamcinolone, and prednisolone ointment are used.
Preparations with vitamin D3 (tacalcinol, maxacalcinol, calcitriene, daivonex). Inhibits cell division of psoriatic manifestations. They have proven themselves to be effective in combination with betamethasone (Taklonex ointment).
Coal tar or tar. It is a weaker analogue of products containing vitamin D3.
Dermatotropic agents (anthralin, micanol, dithranol). Due to the slowdown in the formation of cells that form the manifestations of psoriasis, they can lead to stable remission.
External retinoids (tazarotene, tazorac). Effective for mild to moderate nail psoriasis.
Salicylic acid. Relieves itching, plaque and the upper layers of scales, enhances the effect of other drugs. Combines well with corticosteroid therapy.
5-fluorouracil solution under an occlusive dressing. The course of treatment is up to six months.

If local treatment is ineffective, systemic therapy is started, for which the doctor selects a course that includes:

Cyclosporine. Gives good results for nail psoriasis of any complexity. After a course of treatment, maintenance therapy with Neoral with the same active ingredient, but at a lower dosage, is recommended for 2 years.

Methotrexate(antimetabolite group). It is used for generalization of the process; it has many side effects and contraindications.

Systemic retinoids(acitretin, isotretinoin) are indicated for advanced forms of the disease.

Antidepressants, antihistamines - to reduce itching and manifestations of stress in the patient.

Vitamin and mineral complexes, including zinc, selenium, calcium.

New directions in the treatment of psoriasis:

the use of monoclonal antibodies (rituximab, ustekinumab), which are able to bind to cells of the immune system and destroy immature cells that form manifestations of psoriasis;
biological response modifiers (eg, alefacept). Selectively act on cells of the immune system with impaired protective functions.
necrosis factor blockers (etanercept, adalimumab, infliximab). They are used for advanced stages of the disease and generalization of the process.

Physiotherapeutic and other methods of treating nail psoriasis:

photochemotherapy, phototherapy;
plasmapheresis;
hemosorption;
excimer laser therapy;
diathermy.

Additional measures steps that the patient can take: daily nail care, preventing nails from growing, preventing injury, using gloves for any work involving the action of chemicals, avoiding manicures and decorative nail coatings.

Treatment of psoriasis on the nails with traditional methods

At the initial stage of the disease, traditional methods of treating the disease have proven themselves:

Bay leaf decoction baths. Pour 20 grams of raw material into 2 cups of boiling water and cook for 10 minutes. Cool, keep hands or feet in the broth for 15 minutes. You can take 40 ml orally. 3 times a day.
Lotions on the area of psoriasis using water (500 ml) and oatmeal, corn starch (2 tbsp).
Baths made from infusions of the following plants are effective: sage, string, oak bark, chamomile, celandine.
Ingestion of herbal infusion. St. John's wort, calamus root, string, celandine, lingonberry leaves are mixed in equal proportions. The infusion is prepared at the rate of 1 spoon of the mixture per glass of boiling water, the dosage rate is 50 ml. 2 times a day.
Cocklebur compresses (4 tablespoons of the plant per 500 ml of water) are made as follows: crushed brewed herb is applied to the affected areas and kept under film for 15 minutes.

Prevention of psoriasis on nails

The main methods for preventing recurrence of psoriasis on the nails are as follows:

Sanatorium-resort treatment with stay in a warm climate, including sea bathing.

A diet excluding allergens, alcohol, fatty and fried foods, sweets, spicy foods, smoked foods, and over-salted foods. Including vegetable oils, vegetables, fruits, fish, liver, cereals, and fermented milk products in the diet.

Taking vitamins and minerals.

Timely treatment of infectious diseases.

Elimination of skin microtraumas, protection of extremities from the action of aggressive agents.

Damage to the nails due to psoriasis is called psoriatic onychodystrophy. This disease is a non-infectious pathology, and most often indicates the rapid development of general damage to the human skin. Let's look at what causes nail psoriasis and how to treat it.

Doctors attribute the disease to an autoimmune disease consisting of the rapid synthesis and division of skin cells. During illness, this process exceeds the rate of normal cell growth tens of times. As a result, nails with psoriasis can change color, structure, and are characterized by thickening and separation. In most cases, ailment on the nails indicates the imminent appearance of psoriatic rashes throughout the body. However, psoriasis on the nails often remains an independent disease.

Why does this pathology occur?

The reasons for the development of the disease on the nails, as well as the factors that cause rashes on the body, have not yet been fully studied. Scientists suggest that the main cause of the disease is a malfunction of the immune system, as well as disruption of the body’s normal metabolic processes. Rapid cell division causes a certain immune response; protective bodies, such as leukocytes and red blood cells, are deployed near the lesions, which leads to the process of inflammation of certain areas.

Proponents of another theory claim that psoriasis is inherited. In a third of patients, a family member suffered from the pathology. Scientists believe that humans have genes that cause disruption of normal cell division.

The disease can appear at any age, regardless of place of residence and gender. Next, let's look at some provoking factors of the disease:

cool and dry climate. Such weather conditions may have some bearing on the occurrence of psoriasis;
stress due to injuries, frequent worries and mental stress;
complications of viral and bacterial infections. Psoriasis often becomes a consequence of untreated diseases;
mechanical and chemical damage to the skin;
taking certain medications;
decreased immunity due to poor nutrition;
bad habits;
nail psoriasis can develop due to overwork.

Symptoms of psoriasis on the nails - photo

The disease can develop on both legs and arms. The main symptoms of the disease are as follows:

Tubules, dents and grooves appearing on the nails.
Nail psoriasis is accompanied by darkening of the plate and a change in color. It may be grayish, whitish, or yellow.
Inflammation of the periungual skin and cuticle. Psoriatic patches may appear on the skin.
Nail splitting and detachment. The appearance of deep grooves underneath.
Severe itching, peeling of the skin, splitting of the nail.

Psoriasis of the fingernails is a particularly unpleasant phenomenon. Hands are always visible, and whiteness spoils their appearance, forcing the patient to avoid handshakes and close communication. This often causes a lot of mental abnormalities, such as isolation, irritability and nervousness.

Types and stages of development of nail psoriasis

Nail psoriasis has several types. These include:

Thimble-shaped type. It is expressed by minor lesions of the nails in the form of small depressions and grooves. It is considered one of the most common forms of the disease.
Onycholysis. This type is characterized by detachment of the nail from the body of the finger. Moreover, the patient does not experience severe discomfort or pain. In this case, a border with a pinkish or yellow tint forms around the affected nail.
Onychomadesis. A rather severe form, similar to onycholysis, however, the detachment of the plate occurs faster here, and the formation of a border is not observed.

Also, the pathology is characterized by such a form as hemorrhages under the nail plate. It is divided into the following types:

the appearance of spots and veins under the plate that are pink or red in color and of various shapes;
acquisition of a darker shade by the veins as a result of rupture of large capillaries.

The next type of pathology is trachyonychia. These are changes in the surface of the nail, its coarsening and layering. At a later stage, the plate peels off and its edges bend outward.

Each type can develop as an independent disease or replace each other.

Psoriasis can also be divided into several stages. In medical practice, it is customary to distinguish the following stages of the course of the disease:

First stage. Characterized by darkening of the nail. Furrows and channels of a minor nature may also appear.
Second stage. Coarsening and layering of the plate occurs. The nail changes color and structure.
Third stage. The most severe changes in nails with psoriasis occur in the last stage. The nail plate bends and peels off from the body of the finger. Spots and plaques characteristic of the disease appear.

Why is it important to treat nail psoriasis?

A disease such as psoriasis under the nails is considered an incurable disease. Treatment is always aimed at alleviating the patient’s condition, reducing the manifestations of the disease and achieving stable remission. However, despite the fact that it will not be possible to completely get rid of the disease, drug therapy and other types of treatment are still necessary. This pathology often causes heart disease and is also an aggravating factor in atherosclerosis and many inflammatory diseases. Patients with this disease have a significantly increased risk of heart attack and other complications.

Disorders of the psychoemotional sphere of a person deserve special attention. Patients may develop complications in the form of neuroses, depression, and unsociability. Almost all patients are accompanied by irritability and poor sleep.

When psoriasis manifests itself on the nails, the appearance suffers, the person does not want to appear in public, and avoids communicating with family and friends. In addition, severe forms of the disease can lead to high body temperature, general weakness and malaise.

Nail psoriasis in children also requires proper treatment, since the consequences of the disease can be irreversible deformities of the nails and hands for life. The difficulty of therapy in children is the impossibility of using most drugs, since their effect on the child’s body often causes a lot of side effects.

Treatment methods

In most cases, treatment of the disease requires quite a long time and the use of an integrated approach. Based on the obtained laboratory tests and examination of the patient, the doctor selects the optimal treatment regimen using medications, physiotherapeutic procedures, and traditional medicine recipes are also often used. Next, we will take a closer look at effective medications.

Products for topical application

The following medications are used here:

Medicines based on corticosteroids. These are strong drugs that are used both for nail psoriasis and other forms of pathology. Corticosteroids have many side effects, so they should only be selected by a specialist. This group includes triacort, prednisolone ointment.
Products containing vitamin D3. Such drugs prevent pathologically rapid cell division. These are maxacalcinol, daivonex and others.
Tar-based preparations. To get rid of the manifestations of the disease, pine, birch and juniper tar are used.
Use of salicylic acid. This substance fights well against symptoms such as itching, burning, peeling and irritability of the skin. Often used in conjunction with corticosteroid drugs.

In cases where local treatment is ineffective, doctors resort to the following treatment regimen:

Use of cyclosporine. Provides excellent results for nail psoriasis of any type and complexity.
Methotrexate. Treat as antimetabolites. It is prescribed under the strict supervision of a doctor, as it causes a lot of side effects.
Use of retinoids. Prescribed for severe forms of the disease. This refers to the use of acitrenin, isotretinoin and other agents.
Vitamin complexes - components of zinc, selenium, calcium and other useful elements.

Physiotherapeutic treatment

Physiotherapy methods are also used in combination with drug treatment. These include:

use of light therapy;
use of plasmaphoresis;
treatment by hemosorption;

The use of traditional treatment

To alleviate the condition of a patient with nail psoriasis, products based on medicinal herbs and other natural products are often used. So, the following medications can be used to combat psoriasis:

Bay decoction. Used for baths. To prepare the product, you need to take 15-20 leaves per 1 liter of water and boil the broth over low heat for 15-20 minutes. Then dip your fingers and toes in a warm solution for 10-15 minutes.
Lotions using starch help a lot. To reduce inflammation and itching, you need to treat the lesions with regular corn starch.
A collection of herbs that includes sage, St. John's wort, chamomile, calamus, yarrow and string. A decoction is prepared from the plants, which can be used for lotions and baths.
Application of sea buckthorn oil. The affected areas need to be lubricated with oil 5-6 times a day, after cleaning it from dirt.

Measures to prevent relapse of the disease

Treatment in sanatoriums is very effective. The use of therapeutic mud, mineral water and vitamin complexes gives excellent results. Also, to avoid relapse of the disease, you should avoid eating fatty, spicy, smoked foods, as well as foods high in carbohydrates.

It is very important to give up bad habits and drug use. To get rid of the disease and avoid its recurrence, you should not self-medicate. Only the help of an experienced specialist and a responsible attitude towards your health will help you achieve the desired results.

Nail psoriasis (psoriatic onychodystrophy) is a form of chronic dermatosis. It happens that damage to the plate begins long before the plaque-like rash appears on the body. Pathology can occur as an independent disease. Let's take a closer look at what psoriatic onychodystrophy is and how it is treated.

Psoriasis on the nails is a form of chronic dermatosis

Causes of nail psoriasis

The following can cause psoriasis on the nails:

Hereditary predisposition to the disease. Predisposition to pathology can be determined at the genetic level
Failure in the body's immune system. A consequence of disruption of the normal functioning of protective forces.

Psoriasis is an autoimmune disease, that is, the cause of the skin rash lies in the negative perception of the immune system of epidermal cells. This leads to a significant increase in the growth and division of defective cells of the horny scales of the nails. The body recognizes foreign bodies in them and develops protection. Leukocytes and lymphocytes accumulate in areas of inflammation, which provokes the production of antibodies, and as a result, damage to the nails by the immune system itself.

In addition to the main causes of pathology, there are many provoking factors for the development of psoriatic onychodystrophy:

infectious diseases;
human papillomavirus;
HIV infection;
sudden climate change;
dry, cold weather, lack of ultraviolet rays;
damage to the nail plates;
long-term use of antibiotics, non-steroidal anti-inflammatory drugs, beta blockers and drugs to normalize blood pressure;
frequent stress, nervous breakdowns and prolonged emotional stress.

All this weakens the immune system and provokes its negative reaction in the form of an aggressive perception of its own cells of the epidermis and nail plates.

Weak immunity is the cause of psoriasis on the nails

Types and their symptoms

Nail psoriasis has a rich clinical picture. Depending on the characteristics of the manifestation, there are several main types of damage.

The appearance of pits that spread over the entire surface of the nail in the form of dots is a common form of psoriasis on the nails. Characteristic depressions appear in a chaotic order, their size and number may vary. The difference between this type and other forms is that the affected nail looks like a thimble, hence the name.

Indentations appear on the nails

The nail plate gradually separates from its bed, with no inflammation or pain. A pink rim appears around the affected area. Onycholysis can partially injure the nail or spread over the entire surface.

Depending on how the nail is separated from the soft tissues, psoriasis of this type is:

central;
lateral;
distal.

A distinctive feature of onycholysis is a border around the injured nail and painless detachment of the plate. Initially, a person does not attach much importance to this phenomenon, which leads to a worsening of symptoms.

Onycholysis can affect the entire surface of the nail

There is a rapid separation of the nail plate from the bed. There is no pink rough rim around the affected area. This type of psoriasis is rare and indicates a severe course of onychodystrophy.

The cause of onychomodesis is a significant disruption of nail growth, which provokes rapid rejection of the plate by soft tissues. This type of disease is difficult to treat and is not completely eliminated.

With onycholysis, nails quickly peel off

During the development of psoriasis on the nails, hemorrhages occur under the plate, which manifests itself in two forms:

the formation of red or pink spots that appear through the nails, forming irregular outlines, they are also called “oil spots” or psoriatic erythema;
through the thickness of the stratum corneum, dots or longitudinal stripes of a rich red color appear, which turn black over time.

Subungual hemorrhages are formed due to the destruction of capillaries, which rupture under the heavy pressure of blood.

With this form of psoriasis, subungual hemorrhages appear

In this form, nail psoriasis manifests itself more clearly. The plate becomes thickened and bends upward over time - koilonychia develops. There are additional signs - the surface of the nail becomes rough, rough, and clearly visible irregularities appear.

Trachyonychia appears equally on both the hands and feet and significantly distorts the aesthetic appearance of the nails, making them spoon-shaped. The subungual tissues are most often not injured, but there are cases when hyperkeratosis develops.

With trachyonychia, the nail thickens

With psoriasis of the generalized pustular type, significant compaction and layering of the stratum corneum (onychia) can be observed, which over time leads to destruction and separation of the plate from the bed. The nail crumbles greatly and increases in size. The periungual ridges may become inflamed and thickened - this is the development of paronychia. This condition is characterized by hyperemia and infiltration, which extends to the entire distal phalanx and affects the finger as a whole. The damage can be so severe that pus begins to ooze from under the cuticle and nearby skin.

With nail psoriasis in any form, the toenails suffer more; they become covered with impressive grooves, multiple depressions, various stripes, and sometimes rot. There are cases of such manifestations on the hands, but much less frequently.

The photo shows what all possible forms of nail psoriasis look like on the fingers and toes.

With this form of psoriasis, the nail becomes larger

Stages of psoriasis of the nail plate

In its development, nail psoriasis goes through several stages, which have specific symptoms.

Initial stage. The nail begins to gradually become cloudy. The plate is covered with small stripes, dots, and depressions that resemble a mesh.
Stage of deformation of the nail plate. There is a thickening of the stratum corneum, a change in its color (gray, brown, yellow), the appearance of blood spots and veins under the nail. Purulent discharge is observed from under the inflamed and thickened cuticle.
Advanced stage. The nail on the fingers or toes moves significantly away from its bed, the skin around the affected area is inflamed and covered with plaques, the nail fold festers. Everything else can be accompanied by a bacterial or fungal infection.

The signs of nail psoriasis are always pronounced in accordance with the stage of its progression, so a dermatologist can determine the disease by the external condition of the nail and skin around it.

Consequences

Psoriasis is not completely cured, but only put into remission. The disease is prone to relapses, which become more severe each time. If skin pathology is not treated, it will provoke dangerous consequences.

Any form of psoriasis affects the state of the cardiovascular system, which can ultimately lead to myocardial infarction. This dermatosis aggravates the course of atherosclerosis and inflammatory processes in the body.

Psoriasis threatens a person’s emotional and psychological health with serious consequences. Nervous breakdowns, depression and alcohol abuse are common companions for patients with psoriasis. The result of such disorders can be diabetes mellitus, heart disease, cancer of any location, and aggravation of concomitant chronic pathologies.

Nail psoriasis and bad habits can cause heart problems

In addition to distortion of the nail plate, severe stages of the disease can cause negative disturbances in the general condition of a person:

jumps in body temperature;
disruptions in the normal absorption of folic acid;
weakness and constant fatigue.

It is important not to bring the pathology to a critical state, when the affected nails and skin begin to become covered with ulcers and rot (Zumbusch psoriasis).

Diagnosis of nail psoriasis

Most often, the disease can be diagnosed by the appearance of the nails and the skin around them. To confirm the diagnosis, a scraping is taken from the affected area (plaques, cuticles).

In addition to tests, the dermatologist differentiates the differences between psoriasis and onychia and paronychia of a fungal and infectious nature. To do this, a specialist carefully studies the condition of the nail in order to identify the main symptoms of psoriatic onychodystrophy.

Doctors compare the clinical manifestations of psoriasis and candidiasis, examining the escaping pus and the nature of the localization of the disease on the nails of the hands and feet.

Only after studying all possible signs and excluding diseases with similar symptoms, the dermatologist proceeds to prescribing therapy.

The specialist will examine the extent of the disease and prescribe treatment

Treatment methods at home

It is necessary to combat nail psoriasis comprehensively, using not only combined traditional medicines, but also folk remedies.

Drug treatment of nail psoriasis

Therapy for psoriatic onychodystrophy begins with local medications. These can be ointments, lotions, sprays, creams. The most effective are:

anthralin;
tazorine;
betamethasone;
calcipotriene.

The initial stages respond well to treatment with special varnishes (Belvedere), which slow down or stop the development of onychodystrophy. In addition, it is recommended to treat the periungual phalanges with moisturizing gels.

Belvedere polish will help improve your nails

If the effect of local medications is weak, doctors prescribe systemic medications (injections, tablets). Methotrexate, Acitretin, Cyclosporine help relieve symptoms and improve the condition of nails.

Treatment can take place at home, but it is prescribed exclusively by a doctor, since many drugs have contraindications and can harm a person’s health.

Therapy with folk remedies

What to do if traditional medicine does not produce the desired effect or improvement occurs too slowly? In this case, you can resort to traditional medicine. There are many good recipes that will help enhance the therapeutic effect of pharmaceutical drugs and achieve remission.

Therapeutic baths. To prepare, you need 30 g of bay leaves and 2 liters of boiling water. Place the herb in hot water and simmer over low heat for 5-10 minutes, then let cool to 37-40 degrees. Place your hands (feet) in the prepared broth for 15–20 minutes. Water procedures can be done daily for 1-2 months.
Soda compresses. Dilute 2 tsp in a glass of warm water. soda Soak a cotton pad in the solution and apply to the affected nails for 15–20 minutes. The course of treatment is 10–12 sessions (every other day).
Healing lotions. Mix corn and oatmeal (1 tablespoon each) in 0.5 liters of warm water. Apply a homogeneous paste to the injured areas for half an hour. Therapy continues until improvements are visible.

Lotions with corn flour will improve the condition of your nails

After the procedures, the nails must be carefully processed to allow the medicinal substances to penetrate deeper into the affected plates. To do this, you can use a nail biter (tweezers) and a nail file.

With the help of folk remedies, it is possible to forget for a long time not only about onychodystrophy, but also about psoriasis in general. The main thing is to consult your doctor before starting alternative treatment.

Treatment of nail psoriasis in children

Psoriatic onychodystrophy in a child manifests itself more acutely and is more difficult to tolerate, so if suspicious symptoms appear, therapy should be started immediately. A specialist will explain how to treat nail psoriasis in children.

The first thing you need to pay attention to is nutrition. The diet should exclude:

fried;
smoked;
spicy;
salty;
flour.

You should refrain from eating vegetables and fruits with red pigments (tomatoes, strawberries, cherries).

In the initial forms of pathology, children are prescribed softening and exfoliating external agents:

ichthyol;
salicylic;
naftalan;
tar ointment.

Severe itching can be relieved with antihistamines. For children, Suprastin and Zodak are suitable for such purposes. Desensitizers help well - sodium chloride (10% solution).

Suprastin will help get rid of severe itching

In addition to these remedies, the doctor prescribes medications to increase the body’s protective function. Pyrogenal and Prodigionase are considered the most effective.

In addition to medicinal treatment methods, relaxation on the Black Sea coast (Crimea) helps in the fight against nail psoriasis. It is recommended that children with this dermatological disease be treated at least once a year.

How to distinguish fungus from psoriasis?

Sometimes people confuse psoriatic nail lesions with a fungal infection (onychomycosis). In addition, many people have a question: is it possible to get nail psoriasis? Definitely not. There are several basic signs that help distinguish psoriasis from fungus.

The nail plate, under the influence of onychodystrophy, completely turns yellow, and the fungus causes dark spots over the entire surface.
Non-infectious pathology provokes detachment of the nail from the bed, and the fungus simply deforms the stratum corneum.
Onychomycosis on the feet always causes an unpleasant odor, which is absent with nail psoriasis.
The fungus affects certain areas. On the feet these are the first and fifth toes. It develops mainly between the phalanges and is provoked by diaper rash, excessive sweating, and poor hygiene. While psoriatic nail lesions can occur from any injury.
Onychomycosis develops after contact with a sick person, his clothes, or animals. Factors that cause nail psoriasis are previous infectious or viral diseases, severe stress, and alcohol abuse.

A dermatologist can accurately determine the disease after a thorough examination and necessary research.

Always see a dermatologist for treatment of nail psoriasis.

Prevention

Psoriatic onychodystrophy, like psoriasis in general, cannot be cured, but putting it into remission is quite possible. To prolong the periods of calm of pathology, you need to adhere to preventive measures.

It is necessary to carefully monitor your fingers and toes, adhere to good hygiene, avoid contact with aggressive substances and prevent injury.

Timely treatment of infectious diseases also helps prevent unwanted manifestations of psoriasis.

Damage to the nail plate with its further detachment from the bed is one of the forms of psoriasis. The disease has clear symptoms, so it should not be ignored. Advanced stages are difficult to treat and provoke dangerous consequences. That is why it is so important to take timely measures to eliminate unpleasant manifestations.