What should you know about onycholysis psoriatic arthritis?

Onycholysis means the nail plate lifts away from the skin underneath, often beginning at the tip or sides and creating a pale or discoloured area. In psoriatic arthritis, nail changes may occur alongside joint inflammation or skin psoriasis. Pitting, crumbling, thickening, or a nail that separates can provide useful clues, but onycholysis can also follow repeated minor trauma, manicures, moisture exposure, fungal infection, thyroid disease, or medication effects. The nail finding alone does not establish psoriatic arthritis. Joint pain, swelling, heel pain, sausage-like swelling of a finger or toe, or morning stiffness make a musculoskeletal assessment more useful.

Keep the affected nail short and dry, trim only the loose edge, and avoid pulling it away or placing objects underneath it. Wear gloves for wet work and shoes with enough room if a toenail is involved. Pause artificial nails and harsh products until the cause is clear. Photograph the nail as it changes and note any new joint symptoms or skin patches. A clinician can inspect the nail and may test for infection before choosing treatment. If psoriatic arthritis is suspected, coordinated care may include [Anti-Inflammatory Medication](/treatments/non-surgical-orthopedics/anti-inflammatory-medication/) and [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/).

Arrange medical review for new or unexplained nail separation, especially when it affects several nails or occurs with [Joint Pain](/symptoms/joint-pain/), [Joint Swelling](/symptoms/joint-swelling/), or [Morning Joint Stiffness](/symptoms/morning-joint-stiffness/). Seek prompt care for spreading redness, pus, severe throbbing pain, fever, or a dark colour after an injury. These signs may indicate infection or a significant nail-bed injury.

Could this nail separation be related to psoriasis, psoriatic arthritis, infection, or trauma? Is a nail sample needed? Which joint or skin symptoms should I monitor, and how can I protect the nail while it grows out?