Changes in the Nail May indicate Nail Psoriasis

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.

Facts on Inverse or Flexural Psoriasis

Inverse or Flexural psoriasis is localized in the flexural surfaces of the skin, e.g., armpit, groin, under the breast, and other skin folds. Typically, it appears as smooth inflamed lesions without scaling and is particularly subject to irritation due to rubbing and sweating. This type of psoriasis is often white in color, appears softened as if soaked by water, and may resemble a fungal infection. There is very little scaling, although the patches are inflamed and can be very sore. Appearing as it does in the folds of the skin, it is moister than other forms of psoriasis, and can be more uncomfortable physically. Flexural psoriasis rarely occurs by itself. It is more likely to accompany common plaque psoriasis. Psoriasis sufferers in their middle years or old age are more susceptible to this type of psoriasis as are people who are overweight and have more folds of skin.

Scalp Psoriasis

Psoriasis that affects the scalp is also called seborrheic psoriasis. The scalp may be the first site to be affected by psoriasis. The condition may resemble severe dandruff. Patches of thick, flaky skin may extend to the forehead below the hairline. Scales may build up in the outer ear. Other than the forehead and the ears, the face is usually spared.

However, some people may have patches of inflamed skin that resemble seborrheic dermatitis a type of dandruff eczema that affects the scalp and face.Psoriasis on the scalp is common and, in many cases, it is the only area affected. It usually consists of red, scaly patches that are sometimes lumpy. The edge of the patch tends to be well defined. This type of psoriasis can extend beyond the hairline, onto the forehead. Psoriasis of the scalp does not damage the hair follicle and is not associated with alopecia (hair loss), but if the scale is thick and forms hard lumps, it can lead to temporary hair thinning.

This thinning of the hair is not permanent and will grow back again after the psoriasis clears.This form of psoriasis can be extremely uncomfortable. It is often very itchy, and the psoriatic patches that are inflamed and sore can start to bleed if they are scratched or picked. The condition is not caused by poor hygiene or hair care.

Scalp psoriasis can be demoralizing, as the look of dead skin cells on clothing can be embarrassing, and it is not always easy to brush them off inconspicuously. Itchiness is another big problem, not only because of the social implication but also because it inflames the condition and makes it worse. Forehead along the hairline is a common site as is the temples, nape of the neck, around the ears, as well as the hair parting.

Massaging a little warm baby/olive/coconut oil gently into the scalp, preferably before going to bed to allow plenty of time to soak (bind up the head in an old towel) will help. Wash out with cream shampoo (i.e. Dry Hair Products), add a little lemon juice to the final rinse to get rid of excess grease. Only shampoo three times a week, more than this and the natural oils may be washed out.

Always treat the head as gently as possible, do not comb or brush harshly. Perms and colorants can be used as long as the skin is not broken. Shampoo the hair and scalp with a tar-based shampoo that can be purchased over-the-counter or by prescription. Shampoos, scalp steroid lotions, vitamin D analogues and some tar preparations such as tar pomade may be used on the scalp.

Psoriasis Can Occur In The Ears Too!

Psoriasis is commonly found in the ears too. In this case it can appear as dry scales in the ear canal. It also occurs behind the ear so this area has to be checked to look for the plaques if the diagnosis of psoriasis is considered. The image shows some dryness of the skin in the ear, with some scaling, which is characteristic of psoriasis.

The Importance of Moisturizers in Effective Psoriasis Treatment

Moisturizers or emollients including bath oils, soap substitutes can be applied to the dermatitis as frequently as required to relieve itching, scaling and dryness. Emollients should also be used on the unaffected skin to reduce dryness. Emollient therapy helps to restore one of the skin's most important functions, which is to form a barrier to prevent bacteria and viruses getting into the body and therefore help to prevent a rash becoming infected. Emollients are safe and rarely cause an allergic reaction. Occasionally, products with lanolin may cause a reaction. Ideally, moisturizers should be applied three to four times a day. Apply in a gentle downward motion in the direction of hair growth to prevent accumulation of cream around the hair follicle (this can cause infection of the follicle).

Basic Facts on Psoriasis

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.

Is Psoriasis an Immune System Disorder?

Researchers believe the immune system sends faulty signals that speed up the growth cycle in skin cells. Certain people carry genes that make them more likely to develop psoriasis, but not everyone with these genes develops psoriasis. Instead, a "trigger" makes the psoriasis appear in those who have these genes. Also, some triggers may work together to cause an outbreak of psoriasis; this makes it difficult to identify individual factors.
Possible psoriasis triggers include: emotional stress; injury to the skin; some types of infection; reaction to certain drugs. Once the disease is triggered, the skin cells pile up on the surface of the body faster than normal. In people without psoriasis, skin cells mature and are shed about every 28 days. In psoriatic skin, the skin cells move rapidly up to the surface of the skin over three to six days. The body can't shed the skin cells fast enough and this process results in patches also called "lesions" forming on the skin's surface.