Psoriasis nails

The nails are often affected by the psoriasis. This is known as "ungual psoriasis", or psoriasis of the nails. Psoriasis of the nail affects about half of the patients with psoriasis. The nails of the hands are more frequently involved than those of the feet.

Disruption of the keratinisation process results in an accelerated growth rate which alters the physical appearance of nails.

The psoriasis nails may be the only area affected at the beginning of psoriasis, particularly in children,, making nails pitted or ridged. Because of its location, psoriasis of the nails can be painful.

People who have had psoriasis for several years are however at greater risk of developing nail lesions than those who have recently developed psoriasis.

What are the symptoms of psoriasis nails?

The nail becomes thickened and its surface covered with pits, making it resemble a thimble.

In many cases the nail can be easily lifted away from the finger (nail separated from the nail bed is also called onycholysis).

Other lesions may be observed: skin under the nail may become thicker (subungual hyperkeratosis), longitudinal ridges and transverse lines can appear, and it may also become discoloured with yellowish or salmon-coloured patches. Sometimes the nail turns whitish and opaque; this is known as leukonychia. In general the nail may become discoloured, fragile or flaky.

Nails can be completely dislodged or destroyed by this condition.  

The inflammation can also extend under the nail, in which case lesions are not in contact with the air and heal with difficulty.

Is psoriasis of the nail always associated with lesions on other parts of the body?

The nail is sometimes the only site to suffer lesions, but equally, psoriatic lesions may be present on other parts of the body. It appears that people with generalised psoriasis have a greater predisposition to develop psoriasis of the nail. However, patients can suffer severe psoriasis of the nail without having other serious skin lesions.

It is known that the vast majority of patients who develop psoriasis of the nail will also suffer from psoriatic arthritis, one of the severe forms of the condition.

Do psoriatic nails become infected more easily than healthy nails?

When the nail becomes detached from