The term "nail psoriasis" refers to a disease characterized by damage to their plates. Pathology has a non-infectious nature. Despite this, its course not only worsens the appearance of the hands and feet of a person, but also contributes to the development of diseases of the organs of the cardiovascular and endocrine systems. In addition, in most patients with psoriasis of the nails on the hands or feet, instability of the emotional background is noted, which is due to dissatisfaction with their appearance.
Causes
The disease is autoimmune. A malfunction in the body's defenses leads to a disruption in the formation of cells and the fermentation of substances. As a result, the process of forming an incorrect immune response is launched. Due to this, division and growth of immature cells of the nail plate and epidermis occur. The body perceives them as alien aggressors and organizes the fight against them. This happens as follows: lymphocytes and white blood cells in large quantities are sent to the lesion, which leads to the development of the inflammatory process in some areas of the skin and nails.
One of the causes of the disease is also a genetic predisposition. An anomaly for years can occur in a latent form. Its activation can occur under the influence of various adverse factors. The risk group includes people whose immediate relatives suffered from the disease.
Nail psoriasis can occur at any age. Provoking factors are:
- Climatic conditions. Cold and dry weather often causes the primary development of the disease, as well as the occurrence of relapses.
- Staying long under stress.
- Not completely cured infectious diseases of a viral and bacterial nature, for example, pharyngitis, HPV, tonsillitis. The trigger factor is the presence of HIV.
- Violation of the integrity of the skin due to scratches, abrasions, cuts.
- Taking certain medications (beta-blockers, NSAIDs, lithium-containing drugs, chloroquine, normalizing blood pressure, containing female sex hormones).
- Violation of metabolic processes.
- Hormonal imbalance.
Thus, the main causes of nail psoriasis are: disruption of the immune system and a hereditary predisposition. Under the influence of various starting factors, the risk of a disease increases significantly.
According to statistics, nail psoriasis is most often diagnosed in males under the age of 20, as well as in older people.
Symptoms
The clinical picture of the disease depends on the form of the disease and its severity. Most often, the following symptoms are found in patients:
- Recesses on the surface of the plate are of a point character, a dent and a groove.
- The presence of a border of inflammation located along the edge of the nail.
- Color change plate. It can turn yellow, gray or brown. In addition, the affected plate is characterized by dullness and increased fragility.
- Involvement in the pathological process of the skin of the fingers, manifested by severe peeling.
- The presence of characteristic psoriatic plaques on the surface of the nail. Often, oil stains can also be found on the plate.
- Exfoliation of the nail, detaching it from the finger. Against the background of this process, the formation of deep holes on the bed.
- Capillaries and bruises are visible through the nail plate.
- The formation of growths and bulges that are the result of pathological proliferation of connective tissue.
- The release of purulent contents from under the nail with light pressure on it.
- Itching of the skin around the plate. Symptom can be both weak and pronounced.
Each patient has an individual intensity of symptoms.
Types of disease
Pathology takes several forms. Each of them has certain symptoms.
Types of Disease:
- Pimpled psoriasis. It is considered a classic form of the disease. It appears in the form of point depressions on the surface of the plate.
- Onycholysis. This form of the disease is characterized by a gradual separation of the nail from the bed. In this case, inflammation does not occur, and the person does not feel any discomfort.
- Onychomadez. The mechanism of development of this type of pathology is similar to the previous one. The difference lies in the fact that with this form, the spread of the pathological process is higher. Onychomasis is extremely difficult to treat.
- Hemorrhages. Hemorrhages under the nail can have both a red and a darker shade (up to black). In the latter case, this indicates damage to large capillaries.
- Trachionichia. It is characterized by a change in the surface of the nail plate. It becomes uneven and rough. In some cases, its flattening occurs, and over time, its edges are bent upward.
- Psoriatic paronychia. With this type of disease, the skin around the affected nail thickens and becomes inflamed.
Each of these forms requires a specific approach to treatment.
Developmental stages
Experts divide the course of the disease into several stages. As each of them passes, the nail undergoes certain changes.
Pathology has the following stages:
- First one. It is characterized by darkening of the plate. In addition, at the initial stage of nail psoriasis, the formation of point depressions, transverse and longitudinal strips.
- Second. At this stage, the plate thickens, its color changes. It can turn gray, yellow or brown. Often, streaks of blood are found under the nail, and purulent contents are released from under the plate.
- Third. This stage is characterized by the separation of the nail from the skin. This process is often accompanied by the addition of a bacterial or fungal infection. The precursors of complete nail atrophy are oil stains or characteristic plaques.
Psoriasis of nails on the arms and legs is an incurable disease. Nevertheless, it is necessary to consult a doctor when the first alarming signs appear. Timely treatment helps to maintain the quality of life at the same level and increase the duration of the period of remission.
Diagnostics
If alarming symptoms occur, consult a dermatologist. Only a competent specialist will be able to determine what kind of disease it is - nail psoriasis, a fungus or other pathology.
Diagnosis of the disease consists in examining the patient. At the first and second stages of the disease, the appointment of a blood test is impractical. This is due to the fact that an increase in the number of leukocytes and an increase in ESR occurs only with a severe form of the disease. To make an accurate diagnosis, a doctor may prescribe a biopsy of cells taken from pathologically altered areas.
Treatment
Nail psoriasis is a disease that requires an integrated therapeutic approach. All medications are selected individually, taking into account the health characteristics of each patient.
In the first and second stages, the treatment of nail psoriasis is the use of local drugs:
- Corticosteroids. Hormone-containing creams and ointments are the basis in the therapeutic scheme. As a rule, doctors prescribe the following agents: Prednisolone, Triamcinolone, Triacort.
- Containing Vitamin D3. It is necessary to stop the progression of the disease. This is due to the fact that vitamin D3 inhibits the process of division of pathological cells. Examples of drugs: Maksakalcinol, Dayvoneks, Takalcinol, Calcitriene. The greatest effectiveness of such funds is shown in combination with ointments and creams based on betamethasone.
- Dermatotropic drugs. Designed to increase the duration of the remission period. In most cases, experts recommend using: "Ditranol", "Mikanol", "Antralin".
- Retinoids. They are also effective against severe psoriasis of nails. Examples of drugs: Tazorak, Tazaroten.
- Salicylic acid. The tool not only eliminates the discomfort, but also enhances the effect of other medicines used.
- A solution of 5-fluorouracil. The drug treats the affected area, then an occlusive dressing is applied to it.
Also, nail polishes show good efficacy in psoriasis of nails. Currently, many names of such tools are being implemented. As a rule, doctors recommend using Clobetasol.
The duration of treatment for nail psoriasis is about 6 months. If the prescribed scheme is ineffective, the doctor draws up a new one, including the administration or intravenous administration of the following drugs:
- "Cyclosporin." An effective remedy used in psoriasis of nails of any shape and severity.
- "Methotrexate." Antimetabolite, which has many contraindications and side effects, in connection with which it is prescribed with caution.
- "Isotretinoin", "Acitretin". Systemic retinoids prescribed for severe illness.
In addition, the treatment regimen also includes the intake of vitamin-mineral complexes, antidepressants and antihistamines. For some patients, a doctor may recommend a course of physiotherapy, such as plasmapheresis.
Folk methods
The use of alternative methods of therapy does not exclude the need to seek qualified medical help. Treatment of nail psoriasis at home is advisable to carry out at the initial stage of the development of the disease and only after consulting a doctor.
The most effective are the following recipes:
- Grind bay leaf. Take 20 g of the resulting powder and fill it with 400 ml of boiling water. Put the container on fire. Boil for 10 minutes. After the specified time, cool the broth and place the limbs in it, the nails on which are affected by psoriasis. The duration of the procedure is 15 minutes. In addition, the drug can be taken orally at 40-50 ml three times a day.
- Mix 2 tbsp. l oatmeal with the same amount of corn starch. Pour the resulting mixture with 0.5 l of water. To stir thoroughly. From this tool, it is necessary to make compresses on the nails affected by psoriasis.
- In equal proportions, mix the following medicinal plants (they must first be crushed): St. John's wort, lingonberry leaves, calamus root, celandine and a series. Take 1 tbsp. l Collect and pour 200 ml of boiling water over it. The resulting infusion should be taken twice a day, 50 ml each.
Regular use of alternative medicine prescriptions helps stop the progression of the disease.
Forecast
Currently, nail psoriasis is considered an incurable pathology. In all patients, long periods of remission are replaced by episodes of exacerbation, that is, relapses can occur throughout life.
Timely contacting a doctor improves the course of the disease and preserves the appearance of nails. Ignoring the problem, on the contrary, leads to the appearance of pronounced cosmetic defects, against which a person has an unstable emotional background and a violation of social connections. In addition, pathology significantly increases the risk of developing heart diseases, oncology, and nervous disorders. In isolated cases, a serious complication can occur - psoriasis Tsumbush. The disease requires urgent hospitalization, as it can result in death.
Prevention
To increase the duration of the remission period, you must follow certain recommendations:
- Cut nails as short as possible, do not allow dirt to accumulate under the plates.
- Wear protective gloves when handling the ground, chemicals.
- Choose comfortable shoes strictly in accordance with the size (for psoriasis of toenails).
- Avoid plate damage.
- During manicure use only soft tools that are not capable of causing injury.
- Regularly make baths for nails.
Compliance with these rules significantly reduces the risk of relapse.
Finally
Nail psoriasis is a pathology, the main causes of which are heredity and a malfunction in the immune system. Currently, there is no means that can permanently rid yourself of pathology. However, when the first alarming symptoms appear, you should consult a dermatologist. The doctor will diagnose and make the most effective treatment regimen, against which the discomfort will recede, and the nails will retain their original appearance. Ignoring the problem leads not only to their loss, but also to disruptions in the work of some internal organs. First of all, the nervous and cardiovascular systems suffer.