A few months ago, my right thumbnail began to bend away out from my flesh. Other nails on both hands developed strange patches and became brittle.
I’m on Sulfasalazine, Pregabalin and Amitriptyline, have been for several years. Also often use Tramadol for persistent pain. Now my GP has given me anti-fungal med for my two middle fingers.
I’m, wondering if it’s a (cumulative) effect of my RA meds, either one of them or a combination of two/three?
I am in same boat. Large toenail came off 3 weeks ago. Probably a combination of factors, e.g., age, immunosuppression because of the drugs, etc., rather than a direct drug effect. I too have been offered fungal oral medication but would need to take it for 6 - 12 months to have any effect. I have asked my GP pharmacist to discuss with GP as I am on biologics and methotrexate injections and worried about liver toxicity which anti fungal med can also contribute to. Hope the GP will also discuss with rheumatologist. I have heard that laser treatment maybe an alternate solution but it it is so difficult to get a referral to NHS podiatry/chiropody and whether this is even available on the NHS. Hopefully, you will get some more replies from this worldly wise community. Let us know how you get on and if the anti fungal med works. Best wishes.
Hi. As a retired practice nurse we used to see this all the time. Fungal nails are usually caused by the athlete’s foot virus and yes you can get in your hand nails. You need to remove the cause first and then the fungal nails will start to clear though that that can take up to a year with treatment. If you can’t see an NHS podiatrist it’s def worth going privately ( about £35 per session) if feasible as they can file and trim fungal nails, treat them and generally look after your feet. Doesn’t help to have an auto immune disease which can delay healing so good that you’ve been to your GP.
interesting, I get athletes foot on one foot only with the same pattern/spread every summer but have fungal nails on the same foot all year round and treat with Daktarin 2% which seems to hold it at bay but it’s been present for years now and is painful too. My AI condition of Stills Disease is likely a contributing factor then?
If it isn't fungal, it's a symptom of psoriatic arthritis. I morphed to it from polymyalgia and I didn't have any obvious psoriasis. As soon as the Rheumatologist saw my nails (and a few other symptoms) I had the diagnosis. RA and PsA have similarities.
Interesting as I have the same although it took about 5 years for Rheumy & Dermy to work it out. I also don’t have any other Psoriasis. They decided mine was being caused by Humira & not healing due to Methotrexate so both stopped & it went away.
yes, it crossed my mind but the test results on the nail came back as fungal infestation, hence GP wanting to start oral anti fungal meds.
It could be Ps Arthritis causing it. See my response to CarolKate above.
Hi. Unfortunately I have not had this issue. It could be just a fungal infection. I would see a podiatrist and ask their opinion. Sometimes because we have RA we can link them all together. If I can be if any help please let me know. Take care of yourself xx
Do you have psoriasis? I only ask because I do and my toenails fall off all the time. My nails are badly affected.
Ah sorry...I see you have already been asked this.
I am on sulfasalazine and pregabalin and have been for some years now and have never had the problem you described although I do have problems with my toenails growing away from my skin on my big toes, I just assumed it was because of the toes swelling and the toe bones subsequent deformities. I am under podiatry because of this problem and they haven't said anything about fungal infections. Hope this helps.
Nail Care tips ?
Been having trouble with low blood pressure.
Horizontal nail ridges! 
Fungal nail infection 
