nail psoriasis
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Etiology
Pathology
- subungual hyperkeratosis suggests nail psoriasis[2]
- neutrophils in the nail bed stratum corneum (pathognomonic)[2]
Genetics
- family history of psoriasis helpful[1] Clinical manfestations:
- onycholysis: separation of the nail plate from the nail bed
- areas of white nail at the lateral or proximal edge of the nail plate
- nail pitting: small indentations on the nail surface
- 'oil spots': areas of yellow-tan discoloration at the distal end of the nail plate
- often involves multiple fingernails &/or toenails
- fingernails involved more frequently than toenails[1]
- toenails may be yellow & thickened with subungual hyperkeratosis
- thickened hallux nails may grow over the edge of the toe & abrade skin of adjacent 2nd toe[2]
Complications
- associated with psoriatic arthritis[1]
Differential diagnosis
- see onychomycosis
Management
- screen for psoriatic arthritis[1]
More general terms
References
- ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Medical Knowledge Self Assessment Program (MKSAP) 17, 19. American College of Physicians, Philadelphia 2015, 2022
- ↑ 2.0 2.1 2.2 2.3 Geriatric Review Syllabus, 9th edition (GRS9) Medinal-Walpole A, Pacala JT, Porter JF (eds) American Geriatrics Society, 2016
Geriatric Review Syllabus, 11th edition (GRS11) Harper GM, Lyons WL, Potter JF (eds) American Geriatrics Society, 2022 - ↑ Jiaravuthisan MM, Sasseville D, Vender RB, Murphy F, Muhn CY. Psoriasis of the nail: anatomy, pathology, clinical presentation, and a review of the literature on therapy. J Am Acad Dermatol. 2007 Jul;57(1):1-27. Review. PMID: https://www.ncbi.nlm.nih.gov/pubmed/17572277