Her brittle nails may not be due to her lupus. The most common nail manifestation of lupus is nail fold telangiectasias, which are dilated blood vessels around the cuticle. Brittle nails are most often caused by dehydration and it is important to advise your client to wear gloves for wet work chores, and to moisturize her nails. Brittle nails can be seen in some people with anemia and anemia is common in lupus, so that could be the connection. Raynaud’s Syndrome can also trigger brittle nails and that could also be contributory.
There is no reason that your client cannot have normal nail services including acrylic nails. The products may cause the dehydration to worsen immediately after the acrylic nails are removed, but other than that, there should be no problems. -- Phoebe Rich, M.D.