Nail psoriasis is usually associated with plaque type psoriasis. Only 5% of patients present with isolated nail psoriasis. About 50–80% have psoriatic arthritis and screening is important.
- Nail pitting
- Separation of the distal nail plate from the underlying nail bed
- A translucent red discoloration in the nail
- Thickening under the nail
- Distorted nail
- Red scaly plaques on the dorsum of the hands
It is frequently confused with fungal nail infection. Fungal infection can also complicate nail psoriasis. Nail clippings and scrapings of subungual debris should be sent for microscopy and fungal culture before fungal therapy is considered.
What is the treatment for nail psoriasis?
- Topical and systemic psoriasis treatment
- Avoid nail trauma
- Psoriatic arthritis screening