Patients with nail psoriasis can develop a wide variety of nail ch. (intermediate and ventral portions) form the deeper portion of the nail plate (figure 2). Red spots in lunula: Intermediate and ventral nail matrix involvement. Nail findings that warrant strong consideration of a diagnosis of nail psoriasis include nail pitting, distal onycholysis, oil drop discoloration of the nail plate, and subungual hyperkeratosis. Psoriatic nail dystrophy mainly occurs in patients who also suffer from psoriasis of the skin. Treatment of nail psoriasis includes different types of medications, from topical therapy to systemic therapy, according to the severity and extension of the disease. Alterations of the nail bed due to nail psoriasis include onycholysis, subungual hyperkeratosis, oil drop or salmon spots, dyschromias, and splinter hemorrhages (Figure 2).
Psoriasis of the nail bed presents as oil-drop discoloration, splinter hemorrhages involving the distal third of the nail plate, subungual hyperkeratosis, and/or detachment of the nail plate from the nail bed (onycholysis). Nail matrix features e pitting of the nail plate, f crumbling in proximal quadrants of the nail plate, g leukonychia, h red spot in the lunula. Psoriatic nails are one of the most difficult management problems faced by dermatologists. Figure 2. Onycholysis, oil spots, longitudinal ridging and rough surface of the nail plates. Figure 1: Psoriatic nail involvement most commonly presents as a keratinizing nail unit dystrophy (Courtesy Sean VanMarter, DPM).
Nail Psoriasis: A Review Of Treatment Options