A rash on the skin or scalp in people with psoriasis is almost always accompanied by characteristic damage to the nail plates on the fingers and toes. Changes resulting from the spread of the disease to the nails are commonly called psoriatic onychia in medicine .

Causes

Like other forms of this disease, nail psoriasis has a multifactorial nature and a recurrent nature of the course. The most common causes of psoriatic onychia are considered to be a hereditary (genetic) predisposition of a person, disturbances in the functioning of the nervous system, frequent stress and psychological overwork, chronic diseases of internal organs, disturbances in metabolic processes and metabolism of the gastrointestinal tract, hypersensitivity to external influences of a chemical, thermal or physical nature, circulatory disorders.  

Psoriasis of the nails is not a contagious disease, therefore, contact with the patient does not pose any danger to others. However, for the patient himself, onychia causes a lot of inconvenience, since the disease of the nails on the fingers makes it difficult to perform even the simplest household actions. 

Symptoms

The clinical manifestations of psoriatic onychia are very diverse. Symptoms of the disease may be pruritus, indentations on the surface of the nail plate in the form of dots (the effect of “thimble”), hyperkeratosis and subungual hemorrhages (small hemorrhages), onihomadezis (separation of the nail plate from the nail bed) and onycholysis (nail delamination) koilonychia (spoon-shaped nail ) and trachyonychia (tarnishing, roughness and peeling of the nail).

At the initial stage of the disease, the nail plate becomes cloudy, many longitudinal and transverse grooves appear on it. Pinpoint indentations, like on a thimble, or small pits located across the entire surface of the nail may occur.

Further, the nail begins to flake off due to the developing hyperkeratosis of the subungual skin tissues. Detachment ( onycholysis ) can be partial or complete. First, the edge of the nail plate is separated, and then, as the psoriasis progresses, onycholysis covers the entire nail plate. At the same time, its surface becomes dull, dry, brittle, the nail thickens, and its color changes due to microcirculation disorders accompanying the stage of bed hyperkeratosis. This development of events often entails complications of the disease (bacterial or mycotic secondary infections).

Treatment

To cure nail psoriasis is a complex, painstaking and very long process. To achieve positive results, it is necessary to carry out complex measures, apply various local and systemic drug therapies, supplement treatment with traditional medicine recipes, herbal medicine, and also carry out certain preventive measures.  

To begin with, the doctor prescribes local ointments to the patient, which are based on corticosteroids. These can be drugs Tazarotene , Betamethasone , Calcipotriene and other drugs of similar action. Systemic therapy drugs (Cyclosporin, Acitretin , Methotrexate) are prescribed orally if local therapy does not produce the desired effect.

In addition, psychotropic drugs are prescribed for the treatment of nail psoriasis, since anxiolytics and antidepressants help to normalize the functions of the nervous system and increase the patient’s resistance to stressful situations of various kinds. Sedatives also have an antihistamine effect, which can reduce itching, restore the sleep of a patient with psoriasis, and reduce his irritability.

It is very important to provide proper nail care during the treatment of nail psoriasis and during periods of remission. Nails should always be neatly trimmed, you should not do a manicure on sick nails or perform any cosmetic manipulations, when working, you must always wear gloves on your hands, constantly lubricate your hands with moisturizers and greasy creams.

If you follow all the doctor’s recommendations, then nail psoriasis will recede, and the patient can return to a normal, active life.