Psoriasis in fingernails

** Originally posted by dawsonm **

Does anyone suffer with psoriasis in fingernails? If so, would you please describe your symptoms. I think that is what I have but am not sure. The dermatologist tesed several times for fungus but was negative. He never really diagnosed as psoriasis.

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** Originally posted by Duke767 **

Hi Dawsonm

I think in the finger nails was 3rd place I got p. When I first went to the doctor PCP she gave me Lamsil pills and cream for other areas.which did not work at all and gave me flares I believe. She thought I had fungus but did not test.

I also have PA and so my fingers swell up and also the toes. My symptoms started with getting P underneath the nails and then the white part at the top of the nail comes down more usually for me it is one side of the nail or the other. I have it on my toe nails as well with the same nail changes.

I hope that helps some, I am sure others will have excellent information.

Duke

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** Originally posted by pgerpup **

Hi Dawsonm!

My fingernails have pits like if you were looking down at them from the tips they sorta look like this: ~ Sometimes they hurt, sometimes not. It's worse on my right hand then my left. When I was younger they were thinner and peeled like mica. Now they are brittle and break very easily. Hope this description helps.

Fay

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** Originally posted by RichJ **

hi dawsonm,
sorry i can't help much but welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you.

have a good night all

richard

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** Originally posted by partial **

My toenails had p forever, even though I never had it diagnosed until a major breakout of plaque.

My big toes had what I thought was fungus growing underneath. About 1/4 to 1/2 of the nail had a dark colored tint to the skin underneath. It felt like an ingrown toenail and was painful when I pushed down on it.

My fingernails have had lines in them for years, but I never thought much of it until doing some research and having a huge flair up last summer/fall of p. The nails went from having lines/ridges to major ammounts of pitting and thinning. At its worst, I had no cuticles on any fingernails and the nails were thing and had huge divots in them. It took about 6 months for the really bad stuff to grow out to where I could cut if off.

I also find that my big toes are narrowing and ingrow frequently now. Could be because of always wearing socks at night over Aquaphor to keep my feet from drying out. I find that different brands of socks bind more and put pressure on my toenails, so dont know if that has any correlation to the ingrowing.

Things are somewhat stabilized now and the really bad areas have grown out, but I still have the lines/ridges.

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** Originally posted by Kegrun **

I've had P for about 8-9 years. I just started getting P under my nails about 6 or 7 months ago. If you are looking at your nails from the top, it looks liek a brown spot under it. I also get the divots in my nails. The divots are NOTHING compared to the spots. The spots friggin hurt cause it's actual P growing under the nail. My right hand is the worst..was the worst. My ring, pinky and thumb was getting it bad. The P would rais my nails up and when I would touch them there would be pain in them that I just couldnt stand.

So what I did was, and I dont recommend doing this, I took that little hook thing on a finger nail clipper and started digging the P out till it got to close to real skin. Then I would clip my raised nail part all the way back till I got to close to the sensitive skin. The process hurt, but damn it felt better when i was done. My thumb looked horrible though when i was doing it. My whole nail was jacked up so i cut it all the way to the middle of my thumb and filed away at it. It was about a quarter inch thick and just looked wierd. Plus it would soak up color from food which made it look nasty. I had to tell people that didnt know I had P that I smashed my thumb in a door.

For some reason, the last month or two, my nails have started looking decent again. Speically where I dont have to be embarrased about them. I still have P under them, but they just arent raised as much as they used to be and nobody really can tell they are messed up unless they stared at them. I still do my little procedures on them though.

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** Originally posted by MikeK **

Hi Dawsonm,

Welcome to the board. :cool: Nice to meet you. I'm sorry that you are having issues with your nails. :(

A couple of years ago, my dermatologist shocked me by telling me that my psoriasis has spread to my nails. I knew that they were in bad shape, but I (a) had no idea that it was psoriasis and (b) never even thought of mentioning the problem to her.

I had two very different set of symptoms. My fingernails were dry and brittle. (I was constantly breaking them.) They had white streaks running through them. My toenails were thick (they're very hard to cut) and yellow. They've recently developed the same white streaks as my finger nails. At one time, my left big toe nail was growing in in three seperate pieces.

After telling me that it was psoriasis, my dermatologist told me that nail psoriasis is very hard to treat. The best that she could offer was to inject steroids into the nail beds. She warning that this was very painful and that she couldn't guarantee the results, so I decided to live with the problem.

Shortly after I was diagnosed, I attended an NPF Community Education Meeting in New York. The subject of nail psoriasis came up during the question and answer session. The dermatologist who answered the question said that she was pleased with the results that some of her patients had seen from using a prescription ointment called Tazorac (http://www.tazorac.com or http://www.pdrhealth.com/drug_info/rxdrugprofiles/drugs/taz1429.shtml.) She said that they applied the Tazorac to the base of the affected nail and that the diseased nail eventually grew out. She warned that it was a slow process.

I mentioned this to my dermatologist the next time that I saw her. She told me that she didn't like to prescribe Tazorac because it can cause skin irritation. I insisted so she reluctantly wrote the script. (I did experience skin irritation when I accidently got some Tazorac on my left big toe; even though I wiped it off right away.) I've had mixed results from it. It's help my finger nails. They're no longer dry and brittle. It's down very little for my toenails. They're just as bad as ever.

I've recently had good results from using the Tazorac on the psoriasis on my ankles.

I hope this helps.

Good luck. Keep us posted. Let us know if you have any other questions and please don't be a stranger.

Mike

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** Originally posted by AnnieB **

One sign is that you get spots under the nail that look a bit like drops of oil--they are darker than the skin around them. Very common is skin build up under the nail that causes the nail to separate from the nail bed (onycholysis). I had good results using Taclonex. I had to massage it into the nail bed (the skin at the BOTTOM of the nail) twice a day for five minutes at a time. It cleared it up but took a while because the nail had to grow out.

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** Originally posted by sergecosta **

I occasionally get oil spots under a few nails. However, they grow out and disappear quickly, in my case. They seem to come when I am experiencing a flare even though my psoriasis is very mild. I've found that the less I try to do something about it, the better it is. Since I know that I am sensitive to ingredients in cosmetics and even topical medication, I use warm water to wash and it seems to have made all the difference. I have not had oil spots in a long, long time.

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** Originally posted by vonletztekriege **

I have it to under the nails and it looks just like Fungus
Well I keep them short it helps me allot plus I think scratching makes it worse.
I think the skin gets under the nails and cause's it to flare
John
;)

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** Originally posted by tantev **

Hi,
I had very bad nail psoriasis. I ended up with 9 fingernails and 5 toenails involved. For me, it was not just pitting. The P was slowly seperating my nail from the nail bed. Very painful. I can see how someone might think that it was fungus. It is thickened. It can turn a yellowish color. I ended up going on Enbrel, which has helped me very much. My fingernails now are great (knock on wood) and, while one of my pinky toenails did not fare as well (after losing the nail it only grows now in a very small sliver, right up the middle of where my toenail used to be. I have taken to calling it snaggle toe!) the rest are in pretty good shape. I hope that you are not in too much pain and I hope that you find a treatment that helps.

Victoria

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** Originally posted by bjmacc **

barneys formula may get rid of it but it takes 5-6 months for the nail to grow out. I had it in every fingernail...like wormholes..corresponding with each flair i had...my toenails were yellow, thick and crusty, hard to cut.....

now the nails looks soft, smooth..like a baby's nails.. something to consider...wish i had taken pics..

bj

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** Originally posted by 4Given **

I had pits appear in my fingernails quite a few years ago. They did not hurt but nothing I tried would make them better or go away. Two years ago I started getting little blisters on my left index finger. They did not hurt until they popped then they hurt. Then it started on my right index finger. After the blisters would pop the skin would crack open and bleed, this hurt.

After a couple of months I started getting these little brown spots under my fingernails. At first they did not hurt, when they became closer to the surface under the nail they started hurting. Then my left index fingernail started lifting off from the fingertip back, this hurt pretty bad.

I went to several doctors and dermatologists. I was diagnosed with fingernail fungus, contact dermatitis, dyshydrotic excema, and lastly a "wart" growing under the fingernail.

My relentless internet research kept leading me back to psoriaisis. Everytime I would ask the doctors do you think? , No defininetly not that, was the reply. These diagnosis were arrived at after numerous biopsies and scrapings.

After a year of endless suffering, I continued to research the internet and was led to the NPF website. All of the sudden out of nowhere as if to add insult to injury my right elbow began to hurt pretty bad. I have had aches and pains in other joints before but nothing like this.

Again my research led me to this website and the Arthritis Foundation website. Out of the symptoms of Psoriatic Arthritis, I had all of them except one. I made me an appointment with a rheumatologist immediately. After his intial examination he told me he was pretty sure that I was right with my diagnosis. He took xrays and blood tests, along with those and my obvious skin and fingernail symptoms, he diagnosed me with Psoriatic Arthritis.

Before this website I had never heard of the two diseases combined. Now oh crap I had both of them. My rheumatologist is a very nice guy and he will spend time with you and listen. He placed me on Methotrexate and
Sulfasalzine. My pain in my fingernails started to go away within a few weeks. My fingernails started returning to normal. To me this was and is a blessing. Because I was ready to pull my left fingernail off with a pair of pliers, it hurt that bad. The last time my primary physician saw it he asked me if I wanted him to surgically remove it. I told him no I was hoping to find something that worked and luckily I did. One more month of the pain along with the fact that the nail was over halfway removed on its own, I would have removed it.

I went to a different dermatologist, derm #3, after I saw my rheumatologist. He agreed with me and the rheumatologist and prescribed me Dovonex. This added to my ointment and cream arsenal of clobetasol, elocon, etc....

The sulfasalazine for me was a different story. I turned out to be deathly allergic to it. I contracted Stevens Johnson Syndrome from it and spent five days in ICU with third degree chemical burns on my neck, ears, and face. Five days of IVIG colostrum IV therapy.

Luckiliy for me my wife is a nurse and a doctor friend of ours happened to be familiar with SJS or I might not be here tonight. This doctor took one look at me and looked me straight in the eyes and said this is serious. We have only had four patients in the history of this hospital and the last one died enroute to the burn center. I was admitted to ICU immediately. My fear of MTX had just left, it was no longer a factor to me.

After withdrawing me from sulfasalazine and pumping me full of IVIG colostrum for three days the burns started reversing. Two more days of intense IV around the clock. Then a sixth day in a private room to recover. Amazingly every spot of Psoriasis was gone from my body after five days of the IVIG. My skin had the glow of a newborn, I was baffled and so was my doctors.

Thank God I had good insurance, the medicine bill alone was $80,000 . I paid $3,000 out of pocket on a bill over $120,000 .

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** Originally posted by Brooks_kaylie **

Two of my finger nails on my left hand are pitting.
I tried to hide it with lots of fingernail polish to smooth out the pitting areas.
It bothers me that it's there.
Most people dont noticed it at all.
If P ever got on all my fingers nails .
I would go nuts.


Kaylie

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** Originally posted by JeffR **

My nail p was diagnosed at the same time as the p on areas of my skin. Family doctor initially prescribed Lamisil, but a few months later referred me to a dermatologist.

Topical treatments have helped a lot with the skin stuff, but the nail p has been the biggest challenge. Mine is "moderate" in that it seldom affects the entire nail. Treatment has been successful in controlling, but not in eliminating. Currently using Betamethason DP on the nails and Vanos on hands and elbow.Vanos is the 2nd or 3rd tier of meds.

During the past year, I've taken a vitamin supplement "Hair, Skin & Nails" that I found at Walmart. What I did was take a standard Centrum daily vitamin in the morning and 3 of the supplements throughout the day. A second Centrum after dinner. This, with religious application of the betamethasone as prescribed, has helped stabilize the nail ugliness and help keep it under control.

The above has helped strengthen my nails. When they "go bad" they don't seem to go as bad as they did before. Seems to have worked on both finger and toe nails. Dermatalogist has no problems with the vitamin "therapy".

We need more ideas from those who've had success fighting this nail p!

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** Originally posted by grannyfranny **

Hi Jeff,,,,welcome.
I am interested in the vitamin for skin, hain and nails. I don't have p on my nails but they do breal easily. I am going to look for that.

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** Originally posted by RichJ **

hi jeff,
welcome to the p family. you have met some of the wonderful people on here and will find alot of great info. welcome and nice to meet you. im intersted in vitamin for my hands

have a good day all

richard

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** Originally posted by JeffR **

To the Group:

I've searched YahooGroups using "nail psoriasis", but found no groups with titles indicating a dedicated focus on nail p.

While my research is not all-inclusive, I ask, do any of you know of such an email list? Perhaps through "psoriasis.org"?

If you do, please respond with the list's membership info.

If you don't, then maybe me (or one of us) should start one. The list would focus on nail psoriasis symptoms, medical, holistic, natural and other treatments for nail p as well as nail grooming techniques that may have been part of the success of a treatment regimine.

Your thoughts are important to me, so lets band together and find ways to communicate about this problem.

Jeff

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** Originally posted by WayneIndiana **

Delamination from the bed. first appears as a yellow area under the nail. Do not be surprised if nails thicken and yellow. You are also at great risk for stupid hang nails and eventual ingrown nails. This was the second stage of the disease for me arriving 4 years after the large plaque reaction to polio vaccination. Keep trimmed well. Use nail brush to clean. Use your hands like you have fake fingernails because if you catch one untrimmed. OUCH! You may lose the entire nail down to the bed and root can tear and bleed. Sunlight is about the best approach I have found. And where the area is clear from tip down use an eyedropper to get underneath with hydrocortisone cream. I do not recommend coticosteroids as a tablet for treatment. Remember you are at higher risk for Heart attack. I know. I had one at 41 and had eleven stents over 3 years.

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** Originally posted by airbooster **

I have it behind my fingernails and toenails. As with the others the nails are pitted and brittle. my toenails have been forced outward fom the nailbed by P and when I try to cut them only heavy duty nail sissors does te job. It sounds like you have P but I am not a DR. only your derm can say for sure. airbooster

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** Originally posted by ziggy3064 **

boy can i relate!!! I have very severe plaque psoriasis. both big toenails were removed a couple of yrs ago due to psoriasis. Unfortunately i have it under both thumbnails.the creams help but there is really no way to get the cream under the nail.I had light therapy 3x a week for about 4 months. I had to stop as it was not affordable anymore($20 x3 x a week X16 wks)anyhow the light helped with the psoriasis all over my body but did nothing for the nails.Now here is how i treat my fingernail psoriais as i have not found a surgeon who knows enough about psoriasis who is willing to remove them. I had basically lost the use of my thumbs around christmas time last year because of the pressure underneath.Fells like ya have bamboo shoots under there all the time.God forbid you try to pop the pull tab on the dog or cat food..OUCH!!. and never wash a sinkload of dishes by hand as this just inreases the pressure and the nails sting & throb for a couple of hrs.HERE IT COMES!!!!! I typically use the clippers to get underneath and cut as low as i can and scrape the crap outtta the psoriais under them this takes me about 2 hrs but is well worth it. RESTASIS EYE DROPS.THESE ARE MADE OF CYCLOSPORINE!!!I have severely bad eyes due to graves disease & must use restasis 2x a day.restasis comes in individual vials so each time i put it in my eyes a use the last drops on the fingernails as well as my remaining toenails.this has worked beautifully.slides right under the fingernail.I still have to cut down the nails monthly but my dog & cat are happy to report that i can now feed them with no pain..dermatologist sees no problem with me doing this as it is such a tiny bit of cyclosporine..this has thinned them out beautifully

sorry so long but this has given me the use of my thumbs again..

denise

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