Oil Spot Nail Psoriasis: What to Know

The oil-spot or salmon-patch appearance reflects altered nail growth and inflammation under the nail plate. Nail psoriasis may also cause pits, ridges, thickening, crumbling, separation from the nail bed, or colour change. It can affect one or several nails and may occur with skin or joint psoriasis, although the nail finding alone does not establish the diagnosis.

Fungal infection, trauma, eczema, and other conditions can produce discoloured nails. A clinician may inspect the nail and, when needed, test material from it before choosing treatment.

Keep nails trimmed, protect them from repeated wet work and injury, and avoid picking beneath a separated nail. Use gloves for cleaning and moisturise the surrounding skin. Do not scrape away the patch or apply antifungal or steroid products without advice, because the best treatment depends on the cause and the part of the nail involved.

Treatment may include an injection into the skin near a selected nail or a wider psoriasis treatment such as biologic therapy. Nails grow slowly, so visible improvement may take time even after inflammation is controlled.

Arrange a dermatology review for a new oil-spot change, especially if it affects several nails, causes pain, or is accompanied by skin plaques or stiff, swollen joints. Seek prompt care for pus, marked swelling, rapidly worsening pain, or a dark streak that changes or extends onto the surrounding skin.

Does this nail change fit psoriasis or another cause of discolouration? Would testing help? Which nail care measures and treatment are suitable, and should I be assessed for psoriasis elsewhere or joint symptoms?