I have a client who has broken out with psoriasis on her hands and it has now spread to some of her nails. She has been to many dermatologists (one said it was caused by her artificial nails). Anyway, we have taken the artificial nails off and it has been three months. They are still bad. My client wants them back on so badly. I say no because everything I read says not to add more trauma to the nail plate. What advice can you give me and my client?
It sounds like your client either has nail psoriasis or a contact dermatitis (allergic reaction to artificial nail chemical) or possibly both conditions. Your client needs a definitive diagnosis so that she can be treated effectively to prevent recurrence. Regardless of the cause, it was wise of you to take the artificial nails off as they can make both conditions worse. I would encourage your client to continue the current “nail cosmetic holiday.” If the condition is a dermatitis, with proper treatment and avoidance of the irritant, your client’s nails should improve dramatically. Psoriasis is more challenging to treat and will require seeing a dermatologist for a thorough examination and possibly a nail biopsy if the diagnosis remains in question.
— Dana Stern, M.D. (www.drdanastern.com) is a board-certifi ed dermatologist specializing in nails. She works in private practice in New York City.
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