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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