Toenails and PsA (there is a photo): When I first saw... - NRAS

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Toenails and PsA (there is a photo)

13 Replies

When I first saw the rheumy, he asked about issues with my toenails and I said no. My nails aren’t exactly attractive, but they’ve been the way they are now for so long that I didn’t give it a second thought. My finger nails all have very faint vertical lines with sparse but fairly regular splinter haemorrhages, but no pitting or ridges. Both my thumbnails don’t seem to be bedded down the same way as my other fingers any more, as in the skin doesn’t cover the side of the nail, you can see 2/3 of the nail edge, but other than that there are no particular issues. My toenails on the other hand....

They’re not unsightly - I mean, my dad’s are yellow and properly manky and horrendous and to the best of my knowledge there’s nothing ‘wrong’ with them - but there are features that puzzled me when they first appeared years ago that I shrugged off as one of those things, and I’m now wondering if they’re actually ‘normal’ nail changes for psoriasis/psoriatic arthritis? The pics online all look a lot worse than mine, but I can see similarities. I have the same vertical lines as my fingers on all the nails, quite pronounced on some. They’re also quite thick and brittle, at times they can be quite chalky with buildup under the nail, I also think they’re consistently a bit discoloured. On both big nails I have shallow but very definite horizontal dips - you can see two on the lovely photo I’ve attached.

Bottom line: are these normal nails unrelated to my health, or are they PsA normal nails and I just hadn’t realised until now?

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13 Replies

I would be interested in the answer to this as I too have exactly the same

wishbone profile image
wishbone in reply to

Me too, I've had those lines in my finger and toenails for many years and have never give them a second thought until now. No chalky buildup though.

Brychni profile image
Brychni in reply towishbone

same here

in reply to

Apparently, studies have previously shown that up to 80% of people with PsA also have fingernail psoriasis which includes many of the things I mentioned. I’m going to put a post up, because there seems to be a bunch of us that had no clue!!

Brychni profile image
Brychni in reply to

me too

Boxerlady profile image
Boxerlady

Same here - just assumed that it was normal....

in reply toBoxerlady

Apparently not! I’m going to put a post up, but essentially nails like we all seem to have are a form of psoriasis in their own right and very common in those with PsA.

Lolabridge profile image
Lolabridge

Me too. I have vertical ridges and one or two hollows as well from time to time. All these appeared when I developed lichen planus, my first auto immune problem and have continued as I got diagnosed with RA and subsequently.

Cal48 profile image
Cal48

Look ok to me I was a chiropodist in N HS

Lina282 profile image
Lina282

I have the same so I am interested in the answer too ☺

Caza profile image
Caza

My fingernails are full of lines also pitted. The line on my little finger is split down the middle. Never thought to show my consultant. Not sure about my toenails I have pedicures so I haven’t seen them bare for quite sometime.

LinaM profile image
LinaM

I have the same ... didn’t mention it to my rheumy either 😧Thanks for posting this ..I hope someone can give us the answer !

Yes my nails definitely changed after the RA took hold

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