Nail psoriasis
Overview
Matrix involvement → incomplete keratinization of the nail plate with pitting or trachyonychia. Nail-bed involvement: subungual hyperkeratosis with yellowish discoloration (oil spot), up to onycholysis. Further findings: splinter hemorrhages or nail-bed pustulosis.
As the nail matrix is part of the enthesis apparatus of the finger extensor tendons, matrix involvement frequently co-occurs with joint involvement. About 5 % show isolated nail involvement. Oil spots are considered pathognomonic; histology shows acanthosis and papillomatosis.
Differential diagnosis: alopecia areata, lichen ruber, eczema, mycoses.
Differential diagnoses
- Onychomycosis
- Psoriasis vulgaris (plaque psoriasis)
- Green nail syndrome
- Palmoplantar psoriasis
- Onychoschisis, washboard nails, Mees' lines, and Beau's lines
- Psoriatic arthritis
- Candida intertrigo
- Erysipeloid
Practise Nail psoriasis in the app
Flashcards with spaced repetition, exam questions and spot-the-diagnosis on this topic – in DermaFuchs, free of charge.
In the DermaFuchs app: 4 flashcards · 6 clinical images
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More inflammatory skin diseases
- Cheilitis granulomatosa (Miescher)
- Erythema annulare centrifugum (EAC)
- Erythema nodosum
- Graft-versus-host disease (GvHD)
- Granuloma annulare
- Cutaneous sarcoidosis
- Lichen planus
- Lichen sclerosus
Note: This page is intended for medical education and does not replace diagnosis or treatment decisions in individual cases. Treatment and follow-up content is available in the app.