Nail Pitting and Psoriasis: Causes and Treatment

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Many diseases and conditions can affect nails, making them look differently. Moreover, various types of changes can indicate a wide range of problems, so it is highly important to consult a professional health worker to identify the issue and treat it. One example of the condition that can be diagnosed by examining the patient’s nails is psoriasis, which can be defined as a “chronic, inflammatory autoimmune skin disease” and is often associated with other conditions (Stöppler, 2019, par. 1). The latter can include obesity, heart disease, hypertension, and diabetes.

Psoriasis is not contagious and not curable, and its most common symptoms include reddening of the skin and plaques of dry and itchy skin. The main symptom affecting the nails, and fingernails in particular, is pitting, which is “characterized by depressions in the surface of the nail” (Stöppler, 2019, par. 1). These depressions occur in the superficial layers of the nail plate, and are observed in more than half of the patients suffering from psoriasis. Most often, they look like deformities on the surface of the nail, shaped as lines or small dots. Apart from psoriasis, nail pitting can also indicate dermatitis, some forms of arthritis, and autoimmune diseases, such as “alopecia areata, sarcoidosis, and pemphigus vulgaris” (“Nail Pitting: Causes, Treatment, and More”, 2022). While psoriasis is not a curable disease, some of these conditions are.

Certain treatment exists that allows to relieve some common symptoms of psoriasis. Medical options that are available to people suffering from it can be divided in several categories: topical therapy, light therapy, and oral or injected medications (“Psoriasis – Diagnosis and treatment”, 2022, par. 2). Topical therapy includes corticosteroids, retinoids, calcineurin inhibitors, and anthralin, and light therapy includes “Goeckerman therapy, UVB broadband, UVB narrowband, and psoralen plus ultraviolet A (PUVA)” (“Psoriasis – Diagnosis and treatment”, 2022, par. 4). Finally, oral and injected medications include steroids, biologics, methotrexate, cyclosporine, and others.