Nail Psoriasis can affect both the toenails and fingernails. 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.
Nail psoriasis is frequently associated with psoriatic arthritis. Certain medications may make psoriasis worse. These include lithium (prescribed to treat bipolar disorder, beta blockers (prescribed for heart problems), anti-malarial drugs, and nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen are available by prescription or over the counter for pain relief. NSAIDs are often used to treat psoriatic arthritis. In such cases, the benefits and risks of treatment need to be carefully assessed. Flare-ups of psoriasis caused by NSAIDs usually respond to treatment.