Psoriasis Can Affect The Nails Too

About 50 percent of people with active psoriasis have psoriatic changes in fingernails and/or toenails. In some instances psoriasis may occur only in the nails and nowhere else on the body. Psoriatic changes in nails range from mild to severe, generally reflecting the extent of psoriatic involvement of the nail plate, nail matrix (tissue from which the nail grows), nail bed (tissue under the nail), and skin at the base of the nail. Damage to the nail bed by the pustular psoriasis can result in loss of the nail.
Nail changes in psoriasis fall into general categories that may occur singly or all together:
The nail plate is deeply pitted, probably due to defects in nail growth caused by psoriasis.
The nail has a yellow to yellow-pink discoloration, probably due to psoriatic involvement of the nail bed.
White areas appear under the nail plate. These are air bubbles marking spots where the nail plate is becoming detached from the nail bed (onycholysis).
There may be reddened skin around the nail.
The nail plate crumbles in yellowish patches (onychodystrophy), probably due to psoriatic involvement in the nail matrix.
The nail is entirely lost due to psoriatic involvement of the nail matrix and nail bed.

Factors in the Treatment of Psoriasis

In the treatment of psoriasis, it is important to treat psoriasis in as many ways as possible. Those who modify their lifestyles, eating habits and reduce their level of stress often experience a much greater degree of psoriasis cure. The most visible and distressing symptoms receive treatment, but more can be accomplished by treatment of the cause!

Pustular Psoriasis

This type of psoriasis usually appears as a large red area covered with yellow-green pustules. They tend to be one to two millimeters in diameter and are quite tender. The yellow color is caused by masses of white blood cells (polymorph leucocytes), which flood into any part of the skin that is damaged or infected, in order to fight infection and aid recovery.After seven to 10 days, the pustules become dispersed and a brown scale appears. This scale will start to shed as new pustules develop in other areas, often in a continuous cycle. The most common type of pustular psoriasis affects the palms and soles. It isn't normally itchy however it can be sore or uncomfortable to use either your hands or feet, for example if you are writing or walking.

Plaque Psoriasis

Plaque psoriasis is the most common form of psoriasis. It is characterized by raised, inflamed (red) lesions covered with a silvery white scale. The scale is actually a buildup of dead skin cells. The technical name for plaque psoriasis is psoriasis vulgaris (vulgaris means common). Plaque psoriasis may appear on any skin surface, though the knees, elbows, scalp, and trunk are the most common locations. Sometimes the patches of infected skin are large, extending over much of the body. The patches, known as plaques or lesions, can wax and wane but tend to be chronic. These can be very itchy and if scratched or scraped they may bleed easily. The plaques usually have a well-defined edge and, while they can appear anywhere on the body, the most commonly affected areas are the scalp, knees and elbows. However, if the scalp is involved, you may develop psoriasis on the hairline and forehead. The actual appearance of the plaques can depend on where they are found on the body. Plaques found on the palms and soles can be scaly, however they may not be very red in color. This is due to the thickness of the skin at these sites. If the plaques are in moist areas, such as in the creases of the armpits or between the buttocks, there is usually little or no scaling. The patches are red and have a well-defined border. Chronic (or common) plaque psoriasis affects over 90% of sufferers. It appears usually on the scalp, lower back, elbows, arms, legs, knees and shoulders. It is very much an adult condition.

Scalp Psoriasis

Scalp psoriasis occurs in at least half of all people with psoriasis. It can range from very mild with fine scaling to very severe with thick, crusted plaques. Scalp psoriasis may appear as lesions that extend from the hairline onto the forehead and the nape of the neck. It is common for the psoriasis to appear behind the ears. Scalp psoriasis usually accompanies plaques in other areas of the body. Scalp psoriasis scales appear powdery with a silvery sheen. Possible causes of scalp psoriasis include: scalp treatments and severe psoriasis can both cause temporary hair loss; itching, picking and scratching lesions can worsen the psoriasis by causing a Koebner phenomenon (psoriasis appearing on the site of skin injuries).

Symptoms of Psoriasis

Individuals with psoriasis experience symptoms such as itching, cracking, stinging, burning, or bleeding. Lack of sunlight and low indoor humidity in the winter months can cause the psoriasis symptoms to worsen. The skin is most likely to crack at the joints where the body bends, or in areas where the individual scratches. Scratching should be strictly avoided, because it can cause bleeding and infection. Psoriasis has also been known to cause pits or dents to form in fingernails and toenails. There is also the possibility that the soft tissue inside the mouth and genitalia can be affected. In some cases, psoriasis will cause joint inflammation that produces arthritis symptoms. This condition is called psoriatic arthritis.People with psoriasis may notice that there are times when their skin worsens, then improves. Conditions that may cause flare-ups include changes in climate, infections, stress, and dry skin. Also, certain medicines, most notably beta-blockers, which are used in the treatment of high blood pressure, and lithium or drugs used in the treatment of depression, may cause an outbreak or worsening of the disease.

Psoriatic Changes in the Nails

About 50 percent of people with active psoriasis have psoriatic changes in fingernails and/or toenails. In some instances psoriasis may occur only in the nails and nowhere else on the body. Psoriatic changes in nails range from mild to severe, generally reflecting the extent of psoriatic involvement of the nail plate, nail matrix (tissue from which the nail grows), nail bed (tissue under the nail), and skin at the base of the nail. Damage to the nail bed by the pustular psoriasis can result in loss of the nail. Nail changes in psoriasis fall into general categories that may occur singly or all together:The nail plate is deeply pitted, probably due to defects in nail growth caused by psoriasis. The nail has a yellow to yellow-pink discoloration, probably due to psoriatic involvement of the nail bed. White areas appear under the nail plate. These are air bubbles marking spots where the nail plate is becoming detached from the nail bed (onycholysis). There may be reddened skin around the nail.The nail plate crumbles in yellowish patches (onychodystrophy), probably due to psoriatic involvement in the nail matrix.The nail is entirely lost due to psoriatic involvement of the nail matrix and nail bed.

Psoriasis is a Chronic Skin Condition

Psoriasis is a common immune-mediated chronic skin disease that comes in different forms and varying levels of severity. Most researchers now conclude that it is related to the immune system (psoriasis is often called an "immune-mediated" disorder).It is not contagious. In general, it is a condition that is frequently found on the knees, elbows, scalp, hands, feet or lower back. Many treatments are available to help manage its symptoms. More than 4.5 million adults in the United States have it. Between 10 percent and 30 percent of people with psoriasis also develop a related form of arthritis, called psoriatic arthritis

Treating Psoriasis

Treatment of psoriasis is determined by the location, severity and history of psoriasis in each individual. There is no one method of treatment, for each person with psoriasis may respond differently. One main objective of treatment is to slow down the more rapid than usual growth rate of the skin cells. The rapid growth rate of skin cells causes the red, scaly psoriasis patches. The underlying cause of this increased skin growth is not yet known. For patients with minimal psoriasis, therapy is limited to topical medications that are drugs applied to the skin. For patients with moderate to widespread psoriasis, topical treatments are often combined with ultraviolet light therapy. Either sunlight or artificial ultraviolet light therapy can be used. If topical and ultraviolet light therapy are not effective, or are not practical, systemic or oral medications can be used. These may be combined with ultraviolet light therapy, the so-called photo-chemotherapy or PUVA therapy. In severe cases and unresponsive cases of psoriasis, there are oral medications that slow down the growth rate of skin which are helpful. These drugs can have significant side effects and have to be used with the proper safeguard and caution. Even these strong drugs do not cure psoriasis but only help to control the disease.

Helping Children With Psoriasis

Although medical information is the first thing to communicate about the disease, it is crucial that your child learn to recognize his or her feelings about psoriasis. Typically, when young people develop psoriasis, it not only affects them physically but also emotionally. It may influence how they view and interact with the world, the activities they take part in, the people they seek out as friends and the interests they develop.
Some children show little emotional reaction; others are embarrassed, angry or sad. Children may be apprehensive about their psoriasis getting worse or recurring. Anxiety over rejection by peers is very common, especially as the child moves toward teenage years.
Emotional SwingsPsoriasis presents a range of emotional responses, and coming to terms with having the disease may take some time. No one can predict how a child with the disease will act or feel, because psoriasis tends to fluctuate from worse to better, and the child's feelings will shift as well. The swing in feelings alone can cause confusion. While some children show little in the way of an emotional reaction to psoriasis, others feel embarrassed, angry or sad.
Your child's ability to communicate effectively about the disease and his or her feelings is as important as developing ways to help your child manage the symptoms of psoriasis. Remember that having psoriasis at a young age impacts the patient's body image more severely than in adults.

Seven Ways for Children to Cope with Psoriasis

Seven Ways to Beat the Psoriasis Blues
Prepare your child for the chronic nature of the disease and that it goes through cycles.
Help your child to understand that while this is a genetic disorder, we don't know why some people have it and some don't.
Assure your child that they did not bring on psoriasis. It's not their fault. Make sure the child knows the psoriasis is not her fault because she doesn't eat right, keep clean or has an abnormal personality.
Teach your child patience, with the understanding that some treatments work better than others for them. Tell your child how important it is that they use the medicines properly to control the psoriasis.
Encourage questions and inquisitiveness. Some children are better off writing down their questions. Teens might be interested in camouflaging techniques and other things that help them to feel more in control of their condition. Ensure that they get the answers to their questions from their dermatologist. Discuss their condition, both physically and emotionally, with the dermatologist.
Encourage your child to reach out for support whenever needed and make sure the support is there. Teenagers may find the psoriasis especially distressing, as appearance is extremely important to teens. You can remind teens that educating the people they encounter is important.
Make sure the child understands that while psoriasis might be part of who they are, it's not all of who they are.