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Image Number 428 (Psoriasis nails)

 
Morphology:
Nail dystrophy

Diagnosis: Psoriasis nails

Site: Nails

Sex: M

Age: 43

Type: Clinical

Description: Pitting and separation of the nail plate from the nail bed

Submitted by: Ian McColl

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Differential Diagnosis

History:

Psoriasis of the nails can have a variety of presentations depending on which part of the nail apparatus the psoriatic process involves.If the nail matrix at the base of the nail is involved then you get pitting, occasionally furrows and often a crumbling nail plate.If the nail bed is involved then you get onycholysis or separation of the nail from the nail bed.People often misinterpret this as a fungal infection.Treatment of this condition is very limited.Topical steroid lotions rarely penetrate the posterior nail fold adequately to alter the process.Intralesional steroid injection is very painful.Methotrexate orally can be used for serious nail disease.

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