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Psoriasis of Nails 

Psoriasis is a common skin condition that affects people of all ages. Common manifestations of psoriasis are chronic, scaly rashes that appear in any part of the skin. While it is neither contagious nor due to an allergy, there a people who are genetically predisposed to it, hence there is a tendency that this condition is “inherited” by the members of the family.
Nails can also be affected by psoriasis. When it does, this condition is medically called psoriatic nail dystrophy or, in layman’s terms, nails psoriasis. Most people who suffer from nail psoriasis also suffer from psoriasis of the skin, although there are cases wherein only the nails are affected.

The nails are composed of several parts, including the nail plate, nail bed, nail matrix, hyponychium, cuticle, and nail folds Physical manifestations of nail psoriasis depend on the part or parts of the nails affected and range from unsightly nail discoloration, to pitting, to complete destruction of the nails. Secondary infection has been known to occur in certain cases, like onycholisis. In this condition, which affects the nail bed and hyponchium, the nail plate separates from its underlying attachment to the nail bed and is manifested by the whitening and possible detachment of the nail plate.

There is, as yet, no known cure for nail psoriasis. All one can do is “ride out” the condition and hope that it improves and the nails return to their normal appearance. Since it is a benign condition (i.e., a person with nail psoriasis is not really in any mortal danger because of it), there is really not much to worry about medically. Physically and psychologically, however, nail psoriasis does cause considerable distress for the person suffering from it because of its unsightly manifestations as well as discomfort. To try and help lessen the physical and psychological pain from this condition, there are some treatments that can be tried.

First, one can apply calcipotriol (calcipotriene), a Vitamin-D derivative available in cream and ointment form, on the nail folds. Done twice a day over a prolonged period of time, this treatment regimen may help lessen the severity of nail psoriasis. The controlled application (maximum of two weeks) of corticosteroids may also help. Apply this solution or ointment in the evening on the affected areas and cover these areas with cellophane wrap to ensure that it stays on the affected does not get wiped off or absorbed by the beddings and/or clothes.

Should secondary infection occur, the use of antifungal creams or ointments may be prescribed to help cure the problem. When nail psoriasis is just part of a bigger psoriatic condition, then systemic treatment with oral methotrexate, retinoids, and ciclosporin may be prescribed. Please note that in all the mentioned treatments, it is always best to consult a licensed dermatologist. The effectiveness of a particular treatment varies not only on the area affected, but also on the person affected as well, so just because one treatment works for one particular person, it does not mean that it will work for another person even if it affects the same area.

With proper consultation and the right treatment regimen, the effects of nail psoriasis can be managed while waiting for the condition to run its course.