What should you know about finger nail psoriasis?

Psoriasis can affect the nail-producing area beneath the cuticle or the skin under the nail. You may see pinpoint depressions, a rough surface, yellow-brown colour, debris beneath the nail, or a nail that pulls away from its bed. Several nail conditions can look alike, so a clinician may examine the surrounding skin and, when needed, test material from the nail. Nail psoriasis may occur with skin psoriasis or joint symptoms, but visible nail change alone does not establish the diagnosis.

Keep nails short by filing rather than tearing them, and protect fingertips from repeated knocks. Wear gloves for prolonged contact with water or cleaning products; dry carefully afterward and moisturise the hands and nail folds. Do not scrape beneath a lifted nail or cut the cuticles, because small injuries can worsen separation. A dermatologist may discuss a topical medicine, a steroid injection into the skin, or treatment that works throughout the body, depending on the nail pattern and any other psoriasis. Approved options include Steroid Injection Into The Skin and Biologic Therapy.

Arrange a dermatology assessment when several nails change, the nail is lifting, or the appearance persists despite gentle care. Seek prompt help for increasing pain, warmth, swelling, pus, bleeding, or a rapidly darkening area. Those features can indicate injury or infection and need a separate assessment. Discoloured Nails may have causes other than psoriasis.

Could this be nail psoriasis, fungus, trauma, or more than one condition? Do I need a nail sample or examination for joint symptoms? Which treatment fits the affected nail area, and how should I protect a nail that has separated?