Nail psoriasis is more common in patients who suffer with psoriatic arthritis

February 6^th, 2015

(Uho Health Net News/ General report) What is my causing pitted, discolored, chipped nails, and swollen and painful finger? These may be symptoms of psoriasis. According to dermatologist Wan-Jo Li, these symptoms affect around 50% of people with psoriasis. They are often mistaken for tinea pedis. Tinea pedis is a fungal infection characterized by visibly thickened nails. Nail psoriasis is accompanied by yellowing and pitting of the nails, in severe cases, it may progress into psoriatic arthritis. 

People with nail and scalp psoriasis are at higher risk for psoriatic arthritis

Psoriatic arthritis is linked with skin, joint, and nail symptoms. Nail signs to look out for include pitting, thickening under the nail, discoloration, cloudy appearance, and nail bed separation. Statistics show that around 85% of those with psoriasis have nail symptoms, and they are at higher risk of developing psoriatic arthritis. Dr. Li also reminds that, most patients develop psoriasis first, and psoriatic arthritis tends to appear about 10 years after the first signs of psoriasis. Joint damage is irreversible; meaning that that destructions cannot recover hence must be treated carefully.

Recently, Dr. Li has heard from many patients complaining to her that the symptoms are worst in the morning after waking up. Their joints become very stiff and need a few minutes of warm-up before making any movements or move freely. Psoriatic arthritis flare-ups are most intense in cold weather. Symptoms in the spine (central axis) can be easily missed. Therefore, when you notice frequent stiffness of the body or suspect that you may have arthritis, please ask your doctor to conduct further examination.

Chefs suffering with excruciating psoriatic arthritis showed improved quality of life from biologic treatment.

A teppanyaki chef who suffered from psoriasis with psoriatic arthritis had severe scaly skin and joint deformity, which impacted his performance at work. He was unable to serve customers and had to be reassigned to the kitchen to do food prep. After receiving biologic treatment, his symptoms improved, joint damage stopped, and he returned to his previous position to cooking in the frontline.

According to Dr. Li, biologics with anti-tumour necrosis factor-α (TNF-α) are the standard therapies for psoriasis and psoriatic arthritis. These biologics relieve psoriasis symptoms and manage joint inflammation and destruction. A once every fortnight injection, with regular follow-ups, help the doctors and patients monitor the disease.

Dr. Li also advises that in addition to skin diseases, psoriasis leads to irreversible joint damage, therefore early prevention helps avoid joint destruction. She also reminds psoriasis patients that to manage the disease, it is crucial they maintain a healthy lifestyle, be mindful of any physiological changes, avoid smoking and drinking alcohol, follow doctors order, and attend follow-ups.