Generality
Nail psoriasis - or nail psoriasis, if you prefer - is a particular type of psoriasis that affects the nails, modifying and altering the structure.
Given the marked alterations it causes to the nails, this disorder can negatively affect the social sphere of the patient who suffers, especially when the nails affected by the disease are those of the hands.
Causes
As with other forms of psoriasis, the causes of nail psoriasis have not yet been precisely identified.
However, it is believed that nail psoriasis - in the same way as other types of psoriasis - is caused by a set of factors that contribute to one another in the development of the disease; among these elements, genetic predisposition certainly stands out.
Other factors that can potentially promote the development of the disease are: stress, accidental trauma and wounds, alcohol abuse, various types of infections and the use of certain types of drugs.
Diagnosis
Unfortunately, in some cases the doctor can make a mistake in the evaluation of the disease, therefore in the diagnosis, exchanging the psoriasis of the nails for an onychomycosis. For this reason, great care must be taken and it is advisable to consult a doctor specialized in this area, such as a dermatologist.
However, once diagnosed with nail psoriasis, the doctor can assess its severity through the use of a special index, called NAPSI (from the English " Nail Psoriasis Severity Index ").
Through the aforementioned index, the doctor will assess the severity of different clinical manifestations of nail psoriasis, assigning them a numerical value according to the severity with which they occur.
Clinical manifestations
Nail psoriasis can give rise to various clinical manifestations, among which we recall:
- Thickening of the nail plate;
- onycholysis;
- Occurrence of point-like depressions in the nail plate (this clinical sign is usually called pitting);
- Beau lines, that is the appearance on the nails of more or less deep transversal grooves (in this case, however, it is good to remember that this clinical manifestation is not exclusive to the psoriasis of the nails);
- Subungual hyperkeratosis which appears as a thickening of the yellowish-white nail;
- Gottron spots appear on the nails, that is, spots like oil stains that can be yellow or salmon-colored.
Treatment
The treatment of nail psoriasis varies according to the severity of the disease and depending on whether it occurs individually or in association with other forms of psoriasis.
- In the case in which the psoriasis of the nails is the only form of which the patient suffers, and in the case it occurs in a mild form, usually a topical treatment is undertaken. This treatment involves the use of pharmaceutical formulations suitable for application on the nails and containing active ingredients such as urea, salicylic acid, retinoids, corticosteroids, vitamin D and its derivatives.
- For the treatment of the most serious forms of psoriasis of the nails and / or in the case in which the latter occurs in association with other forms of psoriasis, the doctor may decide to prescribe an oral therapy.
Oral drug therapy involves the administration of immunosuppressive drugs such as methotrexate and ciclosporin and / or the administration of biological drugs, such as, for example, infliximab, adalimumab and etanercept. However, to get more detailed information on this, see the article on " Psoriasis - Psoriasis Treatment Medicines ".
Therefore, the type of therapy to be undertaken for the treatment of nail psoriasis must be prescribed by the doctor on a strictly individual basis for each patient.
