Psoriasis fingernails: signs and care

Changes may affect one nail or several. You might notice tiny depressions, horizontal lines, yellow-brown colour, a nail separating from its bed, or debris collecting underneath. The surrounding skin can become dry, scaly, cracked or tender. Nail fungus and repeated injury can look similar, so appearance alone cannot confirm the cause. Nail involvement can occur with skin psoriasis, but nail changes deserve attention even when skin plaques are limited.

Keep nails short with smooth filing, and avoid cutting or scraping under a lifted nail. Wear gloves for wet work, cleaning and tasks that expose the fingertips to knocks. Moisturise the nails and nearby skin after washing. Avoid biting, picking, artificial nails and harsh removal products if they irritate the area. A clinician can check for infection and discuss treatments applied to the nail or skin, or treatment that works throughout the body when several areas are involved.

Arrange a dermatology review if a nail is painful, repeatedly lifting, crumbling, or changing without an obvious injury. Seek prompt care for spreading redness, warmth, swelling, pus, or fever, which can signal infection. Sudden nail loss or difficulty using a finger also warrants assessment. Bring a list of products and medicines, and mention whether you have joint stiffness or swollen fingers, because psoriasis can affect joints as well as nails.

Could this be nail psoriasis, infection, injury, or more than one problem? Which treatment is suitable for the nail matrix and nail bed? How should I protect a lifted nail? Should I be assessed for joint symptoms?