Health

What is psoriasis?

February 22, 2005 | Bookmark +

What is psoriasis?

Answer

Psoriasis is a condition that most frequently manifests itself on the skin. When the nails are involved, the function of the nail unit becomes impaired. The psoriatic nail may not be able to protect the finger or toe, perceive fine touch or sensation, pick up small objects or scratch. The most common misdiagnosis of psoriasis of the nail is fungal infection. In fact, the signs and symptoms of nail psoriasis and onchomycosis (nail fungus) can be indistinguishable. It is absolutely essential that your client's doctor perform the necessary tests in order to arrive at a correct diagnosis. (It is not a nail technician's responsibility to "diagnose" any nail condition.) The changes in the nail that occur when psoriasis is present include onycholysis (separation of the nail from the nail bed) and subungual hyperkeratosis (thickening of the nail bed). Other signs of psoriasis include splinter hemorrhages, reddish-brown discoloration of the nail bed, and white spots on the nail plate. It should be made clear that psoriasis of the nail is a serious and often disabling condition. It should be accurately diagnosed by a physician who will perform the necessary tests (including a KOH wet mount, culture, and possibly a nail biopsy) before starting treatment. After confirming that nail psoriasis is present, an appropriate and safe routine should be established, tailored to the type and severity of the disorder. Clients with nail psoriasis should not wear acrylics because the acrylic can sometimes aggravate the condition.

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What’s the cause of the pinkish-red oval area on the pad of my client’s toes?

I have a client who has a recurring problem with her fourth toes during the winter months. Both of her “ring finger” toes develop a pinkish-red oval area on the pad. Then a month later, when I see her again, the skin has become dry and hard like a callus, with the layers of skin peeling away to reveal a deeper, dark epicenter.  It’s extremely painful for her and, needless to say, we do not touch it. But it clears up in the summer when she’s wearing open-toed sandals, so I suspect it has to be due to the boots she wears in the winter. Plus she never puts lotion on her feet or uses a foot file in between visits. What do you think causes this?

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What are the big white spots on my natural-nail client’s nails?

I have a client who has been with me for about two years. She used to wear acrylic nails but has been a natural nail client for eight months or so. She has these white spots on her nails — big spots that are dry, but not flaky, right in the middle of the nail. I did try to buff them lightly but they do not come off or grow off. I had a new client come in last week who had the same on her toenails. She said it started after she had a pedicure done at another salon. Can you help?

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