What should you know about pitted nails psoriatic arthritis?

Nail pitting means small depressions have formed in the nail surface. It may occur with psoriasis, but can also have other explanations. Psoriatic arthritis is an inflammatory joint condition that may cause swollen joints, pain, stiffness after rest, or swelling of an entire finger or toe. A person with pitted nails may or may not develop joint symptoms; the nail finding is a reason to describe changes clearly, not a forecast of what will happen.

Photograph changing nails in good light and note joint pain, swelling, heel discomfort, or stiffness on waking. Arrange a medical assessment if these symptoms persist or affect hand, foot, or daily function. Treatment may include [Anti-Inflammatory Medication](/treatments/non-surgical-orthopedics/anti-inflammatory-medication/) when prescribed, alongside tailored [Physiotherapy](/treatments/physiotherapy-and-rehabilitation/physiotherapy/) for movement and strength. Avoid picking or aggressively cleaning beneath the nail.

Seek prompt assessment for a newly swollen, hot, or very painful joint, rapidly worsening stiffness, or difficulty using a hand or walking. Urgent care is appropriate when severe joint pain follows an injury, fever accompanies a hot swollen joint, or a finger or toe changes colour or sensation. Nail pitting without joint symptoms still merits routine review if it is new, widespread, or persistent.

Ask: Could the nail changes have another cause? Do my symptoms suggest inflammatory joint disease? Should I see dermatology or rheumatology? What should I track between visits?