What should you know about psoriasis affecting nails?

Nail psoriasis may affect the nail matrix, which forms the nail, or the nail bed beneath it. Pitting, grooves, yellow or brown colour, thickened debris, lifting from the bed, and crumbling are possible. The skin around a nail may also crack, scale, or become tender. A fungal infection, injury, or another nail disorder can look similar, so a clinician may examine the skin, scalp, and joints and arrange a nail sample when appropriate.

Keep nails short by filing rather than tearing them, protect hands from prolonged water and cleaning chemicals, and use gloves for wet or abrasive tasks. Avoid biting, picking, artificial nails, and cutting the cuticles. Moisturiser around the nail folds can reduce dryness and cracking. Treatment may involve medicine applied to the nail or surrounding skin, treatment for wider psoriasis, or another plan based on the extent and location of disease.

Arrange an assessment for new or progressive nail lifting, persistent pain, swelling, drainage, or a nail that becomes difficult to use. Seek prompt advice if several nails change, because nail findings can accompany psoriasis elsewhere or joint symptoms. Sudden marked redness, warmth, or pus needs evaluation for infection rather than assuming it is psoriasis.

Ask whether the appearance fits nail psoriasis, whether testing for fungus is needed, which treatments can reach the nail, and whether joint pain or stiffness should be assessed.