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Profile: Nail Psoriasis (ungual psoriasis)

Definition: Psoriasis can manifest in the nails, either affecting the nail matrix, characterized by a change in the nail surface with depressions in the form of small dots (punctate deformation), or affecting the nail bed, characterized by a thickening of the nail or skin under the nails (subungual hyperkeratosis), discoloration, detachment of the distal part (onycholysis), and nail deformation. Occurring at any age, in both men and women, it is estimated that this form is common in psoriasis patients (about 35 to 50% of cases). However, isolated nail involvement is rarer.
Internal and external causes: Genetic order; skin traumas; infections; intake of certain medications
How to reduce or eliminate: Local treatments with dermocorticoids, keratolytics, or vitamin D derivatives; intra-lesional injections of corticosteroids; treatment with retinoids (soriatane); intake of immunosuppressive drugs (cyclosporine or methotrexate) for severe conditions; biotherapies (anti-TNF agents).
Preventative steps to take: Avoid micro-traumas to the nails (excessive manicures, over-cleaning, contact with detergents, etc.); wear protective gloves against moisture and external aggressions (manual activities, cold, etc.); apply a water-soluble protective varnish enriched with keratoreductive agents; wash with a soap-free superfatted bar.