Nail Psoriasis : कारण, लक्षण और इलाज

Nail Psoriasis (नाखून का सोरायसिस) एक chronic autoimmune skin disorder है, जो सीधे nails (fingernails और toenails) को प्रभावित करता है।

• यह condition अक्सर psoriasis (सोरायसिस) वाले लोगों में देखी जाती है।
• Nails में changes जैसे pitting, discoloration, thickening, और onycholysis आम हैं।
• Nail involvement कभी-कभी skin symptoms से पहले या independently भी दिखाई दे सकता है।

Nail Psoriasis क्या है  (What is Nail Psoriasis)

• Autoimmune-mediated inflammation affecting nail matrix और nail bed
• Leads to abnormal nail growth and appearance
• Can affect one or multiple nails
• Common nail changes include:
  1. Pitting (small depressions on nail surface)
  1. Onycholysis (nail separating from nail bed)
  1. Discoloration (yellow-brown spots)
  1. Thickening or crumbling of nails
  1. Subungual hyperkeratosis (thick skin under nails)

Nail Psoriasis कारण (Causes of Nail Psoriasis)

1. Autoimmune Reaction

• Immune system attacks skin and nail cells, causing abnormal growth
• T-cells trigger inflammation in nail matrix and nail bed

2. Genetic Predisposition

• Family history of psoriasis increases risk
• Certain HLA-Cw6 gene variants associated with severe nail involvement

3. Environmental / Trigger Factors

• Trauma to nails (nail biting, injury)
• Stress, infections
• Certain medications (beta-blockers, antimalarials)

4. Associated Psoriasis

• Nail psoriasis common in psoriatic arthritis (PsA) patients
• Often correlates with severity of skin involvement

Nail Psoriasis लक्षण (Symptoms of Nail Psoriasis)

• Pitting – small pits or holes in nail surface
• Discoloration – yellow or brown spots under nails (salmon patch)
• Onycholysis – nail separates from nail bed
• Thickening / Crumbling – nails become hard, brittle, and crumbly
• Subungual hyperkeratosis – build-up of skin under nail
• Pain or tenderness in severe cases
• Rarely, nail loss (onychomadesis)

Symptoms may affect fingers, toes, or both।

Nail Psoriasis कैसे पहचाने (Diagnosis of Nail Psoriasis)

1. Clinical Examination – characteristic pitting, onycholysis, nail discoloration
2. Patient History – prior psoriasis, family history, triggers
3. Dermatologist Evaluation – rule out fungal infections (onychomycosis)
4. Nail Biopsy (rare) – confirms psoriatic nail changes
5. Laboratory Tests – mainly to rule out infections or systemic conditions

Accurate diagnosis essential for appropriate treatment।

Nail Psoriasis इलाज (Treatment of Nail Psoriasis)

1. Topical Therapy

• Corticosteroid creams, ointments, or nail lacquers
• Vitamin D analogs (calcipotriol)
• Used for mild to moderate nail psoriasis

2. Systemic Therapy

• Methotrexate, Cyclosporine, Acitretin – for severe or extensive disease
• Biologic agents (Adalimumab, Etanercept, Secukinumab) – effective in psoriatic arthritis with nail involvement

3. Phototherapy / Laser Therapy

• Targeted UV light therapy for nails
• Fractional CO₂ laser in selected cases

4. Supportive Care

• Keep nails trimmed and clean
• Avoid trauma, harsh chemicals
• Moisturize cuticles and nails regularly

Treatment aims to improve nail appearance, prevent pain, and reduce inflammation।

रोकथाम (Prevention)

• Avoid nail trauma (biting, picking, harsh manicure)
• Manage stress and maintain healthy lifestyle
• Early treatment of skin psoriasis to reduce nail involvement
• Control comorbidities like diabetes and obesity

सावधानियाँ (Precautions)

• Avoid self-medication with antifungals without diagnosis
• Protect nails from harsh detergents and chemicals
• Regular dermatology follow-up for persistent or worsening symptoms
• Seek early treatment for pain, nail detachment, or secondary infections

FAQs (अक्सर पूछे जाने वाले प्रश्न)

Q1. Nail psoriasis contagious है?

नहीं, यह autoimmune condition है, और दूसरों को संक्रमित नहीं करता।

Q2. क्या nails कभी पूरी तरह ठीक हो सकते हैं?

सही treatment से improvement संभव है, लेकिन chronic cases में permanent nail changes हो सकते हैं।

Q3. क्या यह सिर्फ fingernails में होता है?

नहीं, toenails और fingernails दोनों प्रभावित हो सकते हैं।

Q4. Nail psoriasis arthritis से जुड़ा हो सकता है?

हाँ, psoriatic arthritis वाले patients में nail involvement आम है।

निष्कर्ष (Conclusion)

Nail Psoriasis (नाखून का सोरायसिस) एक chronic autoimmune condition है जो nail structure और appearance को प्रभावित करता है।
Early diagnosis, topical/systemic therapy, nail care और lifestyle modifications से symptoms improve होते हैं और progression slow किया जा सकता है।
अगर किसी को nail pitting, discoloration, onycholysis या nail pain दिखाई दे, तो तुरंत dermatologist consultation जरूरी है।