Fingernails and psoriatic arthritis: what should you know?

Psoriatic arthritis may affect the small joints near the nails and can cause swelling of an entire finger or toe. Nail changes may include tiny depressions, lifting from the nail bed, thickened debris, ridges, or an altered surface. A fungal infection, injury, or another skin condition can look similar. Tell a clinician whether you also have Joint Pain, Joint Swelling, or Morning Joint Stiffness, and whether symptoms affect one side or several joints.

Photograph changing nails in good light and note when the changes began. Mention scalp or skin patches, heel pain, finger swelling, and any relatives with psoriasis or inflammatory arthritis. Protect nails from biting, picking, harsh chemicals, and repeated trauma. A clinician may examine the nails, skin, and joints and may use tests or imaging to build the diagnosis. Treatment can involve Anti-Inflammatory Medication or Physiotherapy depending on the joints and symptoms affected.

Book an assessment if nail changes persist, several nails are involved, or nail changes occur with swollen, painful, or stiff joints. Seek urgent care for a rapidly hot and swollen joint, fever with joint symptoms, or a finger that becomes severely painful and changes colour. These features can signal a problem needing prompt examination, regardless of the nail appearance.

Could the nail pattern be psoriasis, infection, or injury? Do my joints show signs of inflammation? Should I have nail testing, blood tests, or imaging? Which nail-care products and exercises are appropriate while we clarify the cause?