Understanding Psoriatic Nails and Effective Treatment Options – Expert Insights

2024-01-23 23:30:00

Health Decoding|Psoriatic nails can easily be mistaken for onychomycosis. Suppress inflammatory factors as early as possible and regain a normal life.

When seeing discolored and rough nails, many patients immediately think of onychomycosis. However, this may also be a symptom of psoriasis. In severe cases, it may worsen to onycholysis and deformation of the nails, as well as the appearance of erythema, plaques, and dandruff on the skin. Symptoms, it is advisable to seek medical advice as soon as possible and prescribe appropriate medicine. For the treatment of psoriasis, new biologics introduced in recent years can inhibit related inflammatory factors and have satisfactory effects, helping to improve symptoms and allow patients to return to normal life and regain confidence.

More than a year ago, Ms. Luo (pseudonym), who is in her forties, discovered that her fingernails and toenails were gradually becoming rough, deformed and detached. She thought it was caused by onychomycosis, so she bought a potion to remove the onychomycosis. Treatment, unfortunately, was ineffective. Later, her toenail problem worsened, and her toenails hurt when she walked. In addition, she occasionally shed a lot of dandruff, so she had to seek medical advice. It turned out that she had “misdiagnosed” her illness. After a doctor’s examination, she discovered that psoriasis was the “real culprit.”

Dermatology specialist Dr. Chen Yong said that although onychomycosis and psoriasis can also make patients’ nails rough, psoriasis is often accompanied by skin symptoms, including thick, hard red rash patches and scales, and peeling, including scalp or hair loss. Line rash and flakes falling off are typical symptoms of psoriasis.

The nail surface is sunken, deformed and painful like being chipped by ice

As for nail symptoms, psoriatic nails are different from onychomycosis. “The nail surface of psoriatic nails looks like it has been chiseled by ice, causing a large number of small depressions. In some patients, the nail surface is separated from the nail bed, forming a nail. The white edges of the nails Penetrating into the originally pink nail plate, and nail deformation is also a common phenomenon. On the other hand, the nail surface will appear milky yellow like seeping into stalactites, and the nail layer will also thicken. “

Different from onychomycosis, which is caused by fungal invasion, psoriasis is an immune system disease. The immune system mistakenly attacks the skin, causing continuous inflammation and proliferation of the skin. The common age of onset is between 15 and 30 years old, and between 40 and 60 years old. In addition to skin symptoms, psoriasis may also cause comorbidities such as arthritis, metabolic syndrome, eye and gastrointestinal inflammation, and increase the risk of high blood pressure, diabetes, and high cholesterol.

Dr. Chan pointed out that if psoriatic nails appear, the patient has a higher chance of developing psoriatic arthritis. In addition, many patients feel that the appearance of their psoriatic nails is not good. When in contact with other people, they do not dare to stretch out their hands to avoid embarrassment. In addition to losing self-confidence, their academic, work and social life are also greatly affected.

Biologics curb inflammation

Traditionally, psoriasis has been treated through topical ointments such as steroids, oral medications and ultraviolet light, but the results are limited. As for the biological agents launched in recent years, they can specifically inhibit the inflammatory factors related to psoriasis. Compared with traditional treatment methods, they are more effective and safe. Dr. Chen took interleukin inhibitor 17 (IL17) as an example, which can inhibit the interleukin 17 inflammatory factor. It is a new biological agent for the treatment of psoriasis, which can suppress inflammation and relieve symptoms.

Dr. Chen said that after using biologics, about 80% of the patients’ symptoms improved to more than 90%, and the condition was under control. This helped the patients return to their normal lives and achieve the important goal of treating psoriasis.

Ms. Luo, mentioned above, was prescribed biologics by her attending doctor. After about a month, her condition was under control. The dandruff caused by psoriasis was greatly reduced, her nail problems gradually improved, and her pain gradually subsided.

Dr. Chen reminded that there are various treatment options for psoriasis, each with different effects and side effects. If patients have any questions, they should consult their treating doctor.

Dermatology specialist Dr. Chen Yong

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