Nail psoriasis – never heard of it? Then you are obviously not affected and that’s a good thing. Our nails, whether on our hands or feet, can be attacked by bacteria, germs or viruses and thus be the cause of a variety of clinical pictures. However, nail psoriasis, also known as psoriasis of the nails, is a hereditary disease. Stress, alcohol, smoking, injuries or skin damage caused by, for example, sunburn, medication or even a previous infection can be a trigger for this. Unfortunately, this can hardly be concealed, as the nails show various manifestations of changes in the nail appearance: the nails are deformed, have pinhead-sized indentations (so-called spotted nails) and sometimes scales form underneath the nails, which can cause them to turn yellow or appear very porous or brittle and even lead to nail plate detachment. Nail psoriasis is often associated with pain and does not make it easy for those affected to cope with everyday life, especially as the psychological stress should not be underestimated. On the feet, this can still be concealed by socks and shoes, but on the hands it is visible to everyone.
Who is affected?
Anyone can develop psoriasis on the nails, but the disease usually develops in early adulthood. Mostly in people who already suffer from psoriasis on the skin – the nails are involved in around 30 percent of all psoriasis patients. In rare cases, nail psoriasis also occurs alone. In Germany, around 500,000 people are affected1. In addition to affecting the skin and nails, psoriasis patients increasingly suffer from concomitant diseases such as arthritis (psoriatic arthritis)2. To understand: Psoriasis is a genetically determined excessive immune reaction of the skin. The immune system is not weakened, but works too hard because there is nothing to repair or defend against, instead there is an increased formation of new horny cells, which in turn leads to the formation of scales, according to the expert Prof. Dr. Kristian Reich3.
Is nail psoriasis a nail fungus?
In many cases, nail changes are caused by a nail fungus (also known as onychomycosis ), but they can also be caused by psoriasis. Nail fungus and nail psoriasis can be similar in their symptoms and can also occur at the same time, but the cause is completely different. In such cases, an expert should always be consulted, who can carry out a nail examination and find out the actual cause. Nail fungus can be treated with medication, nail polish or serum to promote the growth of new, healthy nails. A podiatrist can often help here. Regular application is very important, as the process will take longer if the healthy, regrowing nail is attacked again by the bacteria/viruses involved. Patience is required during treatment, as the nail naturally grows back approx. 0.5-1.2 mm per week. Patience is also required for nail psoriasis, as this treatment is very lengthy and complete healing is not always possible. Nail psoriasis should be treated by a dermatologist, often using medication or so-called photo or electrotherapy. Cracks or other changes to the nail as a result of nail psoriasis make it easy for bacteria and fungi to grow, so hygiene is crucial.
