Treatment of psoriasis on the nails

Treatment of psoriasis on the nails

Nail psoriasis or psoriatic onychia is rarely primary. Usually this form develops against the background of an existing disease. It affects about 10% of patients with psoriasis . Interestingly, most often nail lesions accompany psoriatic joint damage . Another feature is the predominant lesion of the nail plates on the hands.
Causes of psoriasis on the nails

Psoriasis of the nails is a chronic skin disease of an autoimmune (with allergy to one’s own tissues) nature. The disease is not fully understood, and many white spots remain in it. But it is known for sure that heredity plays an important role in its development: in one family, several people often suffer from these non-contagious dermatosis. In recent years, assumptions about the leading importance of heredity have been confirmed by genetic research, that is, by the presence of special genes.

But not everyone who has a burdened heredity gets sick. This also requires the influence of certain general and local factors. Common (affecting the entire body) factors contributing to the development of nail psoriasis include:

any chronic diseases and foci of infection;
endocrine and allergic diseases;
eating only high-calorie foods;
regular drinking, smoking;
constant emotional stress, stress, hard physical work;
lack of physical activity, excess body weight;
violation of the “sleep – wakefulness” regime;
violation of peripheral circulation – with atherosclerosis of the extremities, obliterating endarteritis, etc.;
anemia – the nutrition of the nail plates is disturbed;
pre-existing psoriasis of any form, especially psoriatic arthritis .

Local factors (are equally important):

skin infections, especially fungal infections, with damage to the nail plates;
any mechanical and chemical effects on the nail plate.

When exposed to several reasons, metabolism and immunity are disrupted. The body begins to reject its own cells, which leads to the appearance of a psoriatic inflammatory process in the nail area. It is important to notice the problem in time, consult a doctor and start treating the disease.
Symptoms of psoriasis on the nails

Psoriasis of the nails often develops with an already existing psoriatic lesion of the joints. Much less often, it complicates the course of the skin forms of this disease. To understand how the pathological process spreads on the nails of the hands and feet, you need to consider the structure of the nail:

Psoriasis on the nails of the hands is more common, it proceeds slowly and imperceptibly. The nail plate gradually thickens due to the rapid keratinization of the surface layers. One of the first symptoms of nail psoriasis is the appearance of single white spots or longitudinal lines on the nail plates, as well as point depressions, similar to injections. Gradually, the entire nail is covered with such pits (a symptom of a thimble).

With the spread of nail psoriasis, the matrix of the nail (the growth zone, is responsible for the formation of tissues of the nail plate) is affected, which leads to the melting of the tissues of the nail – onycholysis. The process begins with the appearance of a yellow-brown border at the free edge of the nail plate. Then the plate is separated from the bed. Its color, thickness, consistency and shape change. Its surface becomes bumpy, grayish brown or yellow. Further destruction of the plate leads to its atrophy (decrease in volume) or hypertrophy (increase in volume). It often takes the form of the beak of a bird of prey. The condition can be complicated by severe itching.

When the nail bed (the layer of connective tissue under the nail plate) is damaged, subungual hyperkeratosis develops – a thickening of the plate. Oil-like stains appear under the plate (oil stain phenomenon).

Single or multiple punctate hemorrhages also appear on the nail plates. Instead, brown longitudinal stripes sometimes appear, which also indicates hemorrhage.

Toenail psoriasis on the feet is less common. Its manifestations are the same as on the hands. But this form of the disease is sometimes difficult to distinguish from a fungal infection, which has similar manifestations. Sometimes psoriatic lesions on the legs are combined with fungal lesions.

Nail psoriasis can be accompanied by inflammation of the skin and periungual tissues around the nail plate – psoriatic paronychia. When an infection is attached, the inflammation of the affected area becomes purulent.
How to distinguish nail psoriasis from fungus

a fungus is an infectious disease that appears after wearing someone else’s shoes, visiting a sauna or swimming pool, etc.; unlike the fungal psoriatic process, it is not contagious;
the fungus often affects the toenails, and the non-contagious dermatosis on the hands;
the fungus often affects the nails of the extreme toes (1st and 5th) and 1st finger, since it is they who are most injured when wearing shoes and in everyday life; the psoriatic process affects all the nails of the hands or feet; selective damage to the nails allows you to distinguish the symptoms of these diseases;
the appearance of fungal lesions can also be distinguished from psoriatic ones: the fungus causes thickening or deformation of the nail plate, and non-infectious dermatosis – its detachment from the nail bed;
if it is not possible to distinguish it by the clinic, the presence of an autoimmune process is determined by a blood test and a piece of tissue is taken by a biopsy method for histological examination – this is the most accurate method, since the type of tissues affected by the fungus and psoriatic process under the microscope is different.

Stages of nail psoriasis

Psoriasis of the nails is slow and unnoticeable at first. As with other forms, the flow is divided into the following three stages:

initial or progressive – all symptoms are slowly increasing; on time started treatment of nail psoriasis stops the progression and transfers the course to the next stage;
stationary – this stage can be determined by the fact that the disease does not progress, but does not decrease either; this stage can take a long time;
regressing – symptoms gradually disappear; with the correct treatment, the appearance of the limb is restored.

Methods for the treatment of psoriasis on the nails

The question of how to cure nail psoriasis is not worth it. This is a chronic disease that cannot be completely cured. But it is quite possible to prevent relapse. For the treatment of nail psoriasis to be effective, it must be comprehensive and systematic. It should include:

lifestyle change;
diet;
drug (drug) therapy;
modern methods of non-drug treatment;
traditional oriental methods of treatment;
folk remedies.

What medications will help eliminate relapse

Medical treatment of nail psoriasis is a rather complicated task that requires an individual doctor’s approach to each patient. How to treat nail psoriasis, the doctor decides after examination, taking into account the form of the disease, the presence or absence of lesions of other organs and systems, as well as concomitant diseases. Locally prescribed:

Dithranol, Tsignoderm, Anthralin – ointments and creams that suppress the proliferation (too rapid reproduction) of cells formed in the matrix; drugs are toxic, can irritate healthy skin in the nail area;
corticosteroid ointments, creams and solutions – betamethasone (Akriderm, Celestoderm), prednisolone, etc.; suppress inflammation, itching and proliferation;
salicylic ointment 1% – removes dead cells, has antibacterial and antifungal effects;
70% Cyclosporin solution – treatment of affected nail plates in order to suppress immune activity;
tar preparations – has a cleansing and restorative effect;
ointments and creams with a synthetic analogue of vitamin D calcipotriol (Daivonex, Psorkutan);
combined agents – ointments, creams and solutions, which include antipsoriatic agents of different groups.

Taking drugs of general (systemic) action is prescribed for severe nail lesions, which are accompanied by inflammation, itching and pain.
Modern methods of non-drug treatment of nail psoriasis

There are many modern non-drug treatments for psoriatic processes. The most effective are:

PRP – therapy ; relatively recently it was found that platelets (platelets) are actively involved in tissue repair; the method consists in the introduction of platelet-rich blood of the patient taken from his vein into the affected areas of the nail plates; the positive effect of the course of treatment is noted by all patients; even advanced cases of nail psoriasis are treated;
autohemotherapy – intramuscular injection of the patient’s blood taken from a vein; the method is not new, but continues to be applied, as it helps to heal and prevent relapses;
phytotherapy – modern drug treatment regimens usually include specially selected herbal remedies that can potentiate (enhance) the effect of drugs; this helps to reduce the drug load on the patient’s body.

Traditional oriental treatments

In the East, in China and Tibet, persistent remission is achieved with the help of reflexology (RT) – the impact on active acupuncture points (AT), reflexively connected with various organs and tissues.

The doctors of ancient China understood that it was impossible to cure nail psoriasis, but its relapses were successfully cured. Therefore, much attention was paid not only to treatment, but also to the prevention of exacerbations. In their practice, they used various RT techniques – acupuncture (acupuncture) , moxibustion with wormwood cigarettes , exposure to AT with vacuum ( vacuum therapy ), acupressure, including AT on the auricle, etc. The results of this treatment are impressive.

All these techniques are successfully applied today. But you should know that quality training in reflexology can only be obtained in Chinese or Tibetan clinics. In the hands of a real master, using the RT method, you can cure a relapse of nail psoriasis without the use of drugs. Anti-relapse RT courses allow patients to forget about exacerbations for a long time.
Treatment of psoriasis with folk methods

For psoriasis of nails, folk remedies are also used. But you cannot use them without consulting a dermatologist. The psoric process is insidious – at the slightest violation of the rules of treatment, its progression can accelerate. Correctly prescribed folk remedies do not give side effects, they can be used both as part of a complex treatment, and independently (with a mild course). The following folk remedies will help to cure a relapse at home:

compresses (applications) from a decoction of bay leaves ; the broth is prepared at the rate of 15 -20 leaves per liter of water; it should be kept in a water bath for half an hour; after straining, the broth is cooled and used for compresses; suitable for inflammation of the periungual tissues, as it has an antiseptic and anti-inflammatory effect;
salidol ointment ; mix in equal parts medical salidol (buy at a pharmacy) and petroleum jelly; after obtaining a homogeneous mass, apply on the affected nails 2 – 3 times a day for three weeks; promotes rapid cleansing, prevents the development of complications.

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