Health

I have a client who has broken out with psoriasis on her hands and it has now spread to some of her nails. What advice can you give me and my client?

December 02, 2013 | Bookmark +

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?

Answer

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.


Have a health question? (about salon safety and sanitation, nail disorders, science, etc.) E-mail it to Judy.Lessin@bobit.com and check back here for an expert answer.


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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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