Subungual strip-shaped hemorrhages - causes, symptoms, treatment

The general condition of the body is often reflected in the condition of the nails. Therefore, changes in the appearance of the nail plates should be a reason to consult a doctor.

Hemorrhage is a condition in which spontaneous bleeding occurs. If we are talking about subungual hemorrhage, then bleeding will occur in the tissues of the nail bed.

There are two types of subungual hemorrhages. In the first case, spots of different sizes, having shades of red, form under the nails. The second type of subungual hemorrhage is strip-like formations located along the nail bed.

Symptoms of nail psoriasis

This disease has been known since ancient times and the first descriptions of it appeared at the beginning of the 19th century. Back then, doctors had certain difficulties with treatment and diagnosis. But scientists have put forward their assumption that the disease has an isolated form.

In the world of modern technology, experts were able to confirm this hypothesis. Damage to the nail plate in nail psoriasis appears as a concomitant form of the disease. In this case, we are talking about vulgar psoriasis , which can develop independently.

There are several common clinical manifestations of this disease. Most often, patients may experience symptoms of thimble, subungual hemorrhages, onycholysis, and trachyonychia.

How does the disease occur?

With this disease, there is a significant acceleration in the proliferation of epidermal cells. In properly functioning skin, the process of cell proliferation and exfoliation lasts about a month, while with psoriasis it is reduced to 4 days.

As the disease develops, we also deal with changes in the vessels - the process of new ones appearing is very active, they are more dilated and there is increased blood flow in them. Sore spots are red. Dead epidermis accumulates on the surface of the skin. People who suffer from psoriasis have very oily skin.

Thimble Syndrome

This is a common form of nail psoriasis. This problem manifests itself in the form of tiny dimples on the surface. Their diameter reaches two millimeters. The main reason for the development of this form of the disease is a violation of the formation of the plate. The recesses can have different sizes, shapes and depths. They are also , which in appearance is more similar to the surface of a thimble. That is why this disease received this name.

If a person has one or two dimples, then this phenomenon is considered normal and the problem is not classified as nail psoriasis. A similar form of the disease can appear during chronic dermatosis.

What is the danger of pathology for adults and children?

Nail psoriasis is dangerous for adults and children due to its consequences: without treatment, the disease can cause complications in internal organs, joints, and lead to the spread of pathology to the skin. Often inflammation is added to onychodystrophy. In adults, the risk increases:

exacerbation of chronic pathologies of internal organs;
arthritis;
arterial atherosclerosis;
heart attack;
neuroses;
depression.

Nail psoriasis is just as dangerous for children as it is for adults. Often, onychodystrophy occurs against the background of endocrine disorders (diabetes mellitus), vitamin deficiency, which pose a threat to the baby’s life.

Onycholysis

This is a fairly common problem that occurs in many patients. This pathology is characterized by damage to the nail plate and its gradual rejection from the bed. In this case, the patient does not feel any inflammatory reactions or manifestations. The separation of the nail begins at the distal edge. The degree of expression can be complete or partial.

An empty space forms under the peeled nail , where particles of dust, dirt or air bubbles can get trapped. Here, dead epidermis gradually accumulates, which can give the nail plate a gray-white tint.

Consequences

Today, nail psoriasis is considered an incurable disease. Even with apparent improvements and complete disappearance of signs of pathology, the risk of the disease returning remains throughout the patient’s life. In any form of the disease, the likelihood of developing heart disease, including heart attack, increases, and the course of inflammation and arterial atrosclerosis is complicated.

Against the background of the disease, the development of chronic pathologies is often complicated. In many cases, psoriasis causes emotional and social consequences. Many patients are accompanied by depressive states, neuroses, and they develop alcoholism.

In complex cases, deformation of the nail plate occurs, causing deformity. It becomes impossible for the patient to appear in public places. Patients' body temperature rises, the absorption of folic acid is impaired, and they feel weak.

Nail psoriasis does not pose a danger to others because it is not contagious and has no infectious consequences.

Possible complications

If psoriasis is detected, it must be treated immediately, otherwise serious complications may occur:

jumps in body temperature;
development of arthritis and atherosclerosis;
weakness and increased fatigue;
disruption of the cardiovascular system;
worsening existing inflammatory processes;
depressive states, nervous disorders;
loss of nails and development of putrefactive processes in the affected areas.

Prevention of nail psoriasis

The basic rules for a successful course of treatment procedures, in addition to an integrated approach, are also:

daily observance of personal hygiene rules;
careful attitude towards one’s own health, including nails damaged by disease;
balanced diet;
if fingernails are damaged, do housework using chemical cleaning agents only with protective gloves;
it is necessary to protect the nervous system;
strengthen the immune system.

An excellent way to consolidate the high therapeutic result of complex treatment prescribed by a doctor is therapeutic and preventive procedures in a sanatorium. Special muds that have a wide range of effects on many skin diseases will help prevent recurrent psoriasis.

Subungual hemorrhage

There are two types of subungual hemorrhage, which differ in their varied characteristics. In the first case, patients are faced with the appearance of spots on the nail plate that have different colors and sizes. The disease presented is called oil stain syndrome.

In the second case, subungual hemorrhages are characterized by stripe-like hemorrhages of reddish, brown or black shades. This type of disease develops after blood capillaries rupture.

Is it possible to cure the disease forever?

Nail psoriasis is incurable. Even with apparent improvement, a relapse will still occur after a while. The disease can only be put into remission and try to avoid provoking factors and take maintenance medications.

Measures to prevent relapse of the disease

Treatment in sanatoriums is very effective. The use of therapeutic mud, mineral water and vitamin complexes gives excellent results. Also, to avoid relapse of the disease, you should avoid eating fatty, spicy, smoked foods, as well as foods high in carbohydrates. It is very important to give up bad habits and drug use. To get rid of the disease and avoid its recurrence, you should not self-medicate. Only the help of an experienced specialist and a responsible attitude towards your health will help you achieve the desired results.

Trachyonychia

10% of patients who experience nail psoriasis develop trachyonychia. It has several features - the roughness and dull color of the surface of the nail plate. In this case, the hole at the base of the nail is completely absent.

There are cases when the presented pathology is accompanied by coyolonychia, then a small depression appears in the center of the plate. If you immediately seek help from a qualified specialist , you can avoid serious problems. As the nail thickens, after a few weeks it may gradually take on a concave shape. The subungual tissue is not subject to any changes or pathologies.

Stages of the disease

There are several stages of nail psoriasis, with the onset of which the symptoms of the disease change:

Stage one. The nail begins to darken and become cloudy, small vertical and horizontal stripes and depressions appear, and occasionally a kind of mesh appears on the plate.
Stage two. The plate thickens and changes color, which may become greyish, yellowish or brown. When hemorrhagic type of nail psoriasis occurs, blood streaks appear under them. In some cases, purulent discharge occurs.
Stage three. The nail separates from the toe and may be accompanied by a bacterial or fungal infection. At this stage, the disease is considered advanced. Detachment of the nail may be preceded by the appearance of oily brown-yellow spots and psoriatic plaques.

How to properly treat nail psoriasis?

A large number of people do not know how to properly treat nail psoriasis. It is worth noting that this is a rather lengthy and labor-intensive process that will require a lot of effort. At the first signs of psoriasis, the patient should seek qualified help. Only a doctor can determine the cause of the pathology and prescribe effective treatment.

Nail psoriasis can be chronic, recurrent and wavy. The main condition of therapy is proper and regular care of affected as well as healthy nails. Important rules have been drawn up for patients that must be followed during treatment:

cut your nails short;
try to prevent microtraumas from occurring;
procedures such as manicures and pedicures should be postponed;
You should wear gloves when doing household chores and washing dishes.

For any damage to the nail plate, patients are advised to take a vitamin complex selected for them by their doctor , which should contain a high amount of beneficial microelements. In order for nails to have the correct shape and form in the right direction, it is necessary to pay attention to a sufficient intake of potassium, calcium, silicon and zinc in the body. It is these recommendations and useful tips that will help you avoid such problems as nail psoriasis. Photos of the affected nail plate and the consequences of improper treatment can be viewed in the doctor’s office.

But if the patient has an acute stage of the disease, then you should refrain from taking the medications presented. They are also not used in case of possible individual intolerance. Mild psoriasis does not require drug treatment from the patient.

In this case, it would be advisable to use useful medicinal varnishes that will effectively hide possible defects. The process of nail damage will be slowed down and repeated relapses will be prevented. If patients do not seek qualified help in a timely manner, dermatologists prescribe additional local treatment. At the same time, patients regularly use healing solutions, creams and ointments. The duration of such therapy is at least three months.

Causes of the disease

The main reason for the appearance of psoriasis on the toenails and hands is a malfunction of the body’s immune defense, which is manifested by a disruption in the process of cell formation and breakdown of substances. An incorrect immune response provokes the release, enlargement, and division of skin cells that have not yet matured and the horny part of the nail.

The immune system recognizes such cells as a dangerous foreign organism, after which a large number of lymphocytes and leukocytes accumulate near the affected areas. This process causes an inflammatory process - during the production of specific antibodies, an attack occurs on the nail plates and skin.

An additional factor that significantly increases the risk of developing nail psoriasis is hereditary predisposition. In the body of some people there are inherited defective genes that provoke the occurrence of the disease.

There are other factors, due to the impact of which on the body, the development of pathology can begin:

dry, cold weather often becomes a provoking factor for the initial appearance of the disease and its relapses;
frequent experience of stressful situations;
the presence of viral and bacterial diseases - pharyngitis, tonsillitis, human immunodeficiency virus, papilloma virus;
regular damage to the skin;
long-term use of certain medications - drugs containing lithium, beta blockers, drugs whose action is aimed at normalizing blood pressure, non-steroidal anti-inflammatory drugs, hormone-containing drugs.

Treatment of nail psoriasis at home

There are several important points in treating psoriasis at home:

first of all, you should pay attention to taking calcium-based drugs, which will provide the necessary anti-inflammatory effect and reduce sensitivity;
if psoriasis is accompanied by itching, then antihistamines should be used;
careful hygiene of the hands and feet to prevent complete destruction of the nail plate;
it is important to regularly take baths based on beneficial medicinal herbs - chamomile, calendula and sage;
consumption of vitamin complexes that have a positive effect on internal metabolic functions;
the use of ointments, creams and lotions after examination by a doctor and diagnosis.

Psoriasis is a multifactorial disease that is most often observed in young people. The photo shows that the main symptom of this disease is excessive peeling of the nail plate. Exacerbations occur in the winter months.

Treatment of the disease

Treatment of nail psoriasis is a long, labor-intensive process that is based on complex therapy.

The groups of prescribed drugs depend on the stage, type and characteristics of the course of nail psoriasis.

At the first and second stages, the use of topical medications is often prescribed for the treatment of psoriasis:

Corticosteroid creams and ointments are the mainstay of treatment for nail psoriasis. At the first stage, Triacort, Prednisolone ointment, Triamcinolone are used.
Products containing vitamin D3 - Tacalcitol, Daivonex, Calcitriol. The action of these drugs is based on inhibiting the division of cells affected by psoriasis. An increased effect occurs when used simultaneously with Betamethasone.
Tar or coal tar are analogs of vitamin D3 preparations that have a less pronounced effect.
Dermatotropic drug - Anthralin. Neem slows down the formation of cells affected by psoriasis. The use of this remedy helps to achieve long-term remission.
Medicines with retinoids - Tazorac, Tazarotene.
Salicylic acid. Helps reduce itching, reduce plaque, get rid of the top layer of scales, and enhance the effect of other medications. The product can be used together with corticosteroids.

If treatment of psoriasis with local medications is insufficiently effective, systemic therapy is started, which may contain:

immunosuppressive drugs;
antimetabolites;
systemic retinoids;
antidepressants;
antihistamines;
vitamins and minerals.

Causes and symptoms

Nail psoriasis can develop for the following reasons:

hormonal imbalances;
chronic stress;
lack of vitamin E;
pregnancy;
allergy;
permanent mechanical injury to the nails;
hereditary burden;
infection;
immune disorders;
metabolic disorder.

Psoriasis of the fingernails and toenails can occur as an isolated form or as a concomitant form in the presence of symptoms of skin lesions of psoriasis.

Clinical manifestations are variable, but more often nail psoriasis is marked by the presence of: thimble symptom, subungual hemorrhages, onycholysis, trachyonychia.

Diagnostics

The appearance of hemorrhages under the nails should prompt a full examination of the patient. The patient may be referred for a consultation with an endocrinologist to identify or rule out hormonal disorders.

It is important to distinguish subungual hemorrhages from subungual hematomas. Hematomas are formed as a result of trauma - a blow to the nail, a pinched finger, etc. The formation of hematomas is accompanied by severe, twitching pain, so it cannot go unnoticed.

An important point in the diagnosis of nail hemorrhages is to exclude the infectious nature of the disease. An examination for fungal nail diseases is also required, since the manifestations of fungal onychomycosis are very diverse. To carry out the analysis, a scraping is taken from the surface of the diseased nail or a piece of the nail is cut off. The material is sent to the laboratory, where it is inoculated on nutrient media. Such an analysis allows not only to detect the presence of a fungal infection, but also to determine the type of fungi that provoked the disease.

Complications

Nail psoriasis can be complicated extremely rarely, and this is due to the absence or incorrectly selected treatment, certain characteristics of the patient’s body and the low efficiency of the immune system.

Nail psoriasis can develop into psoriatic arthritis, which affects the interphalangeal joints.

First, the patient notices the appearance of pain in the area of the diseased joint, then swelling appears, restriction of active movements in the joint.

With further progression of nail psoriasis, dislocations, ankylosis and persistent deformation of the joint appear.

If psoriasis on the nails is not treated, over time it can lead to loss of ability to work and even the development of disability.

Epidemiology

The main epidemiological factors of psoriatic nail disorders:

There is no seasonality.
There are no age priorities.
More typical for men under 25 years of age.
Hereditary processes account for up to 40% of all cases.
Combined forms – up to 25%.
Lesions with an unknown cause – up to 35%.
The highest frequency of determination of nail psoriasis is characteristic of psoriatic arthritis - up to 90%.

It has been established that the disease is not transmitted through household contact.

Types of damage to the nail plate

Point lesion or thimble psoriasis. The most common psoriasis is on the nails. Its development is characterized by the appearance of pits of small diameter up to 2 mm.

Their development is caused by a violation of the formation of the nail plate. The pits that appear differ in size, shape, depth, and their location is chaotic, which outwardly resembles a thimble; this similarity gives the name to this species. At the same time, their accelerated growth is revealed.

Change in surface structure or trachyonychia

Nail psoriasis is characterized by dulling of the plate, and its surface becomes rough.

There is no visible lune at the base of the nail.

In some clinical cases, this appearance may be accompanied by the appearance of an indentation in the center of the plate, which is called koilonychia.

At the initial stages of development, it flattens, and as it progresses, koilonychia appears, which causes its concave shape, which resembles the shape of a spoon.

With this type, subungual tissues are not involved in the pathological process.

Flaking or onycholysis

This psoriasis on the nails is characterized by gradual thinning, loss of shine, clouding, and due to malnutrition, its color changes.

In this case, the plate slowly but painlessly separates from its bed, and there are no signs of inflammation.

The pathological process begins to develop from the distal edge, but it is also possible from the lateral or center.

Depending on the degree, nail psoriasis is divided into: partial and complete onycholysis.

As the pathological process progresses, particles of dust, dirt and small air bubbles easily enter into the formed empty space. And the epidermis lining the nail bed begins to peel off, which leads to its coloration in a grayish color, but it can be yellow or brown. It is extremely rare that psoriasis on the nails is accompanied by the appearance of an unpleasant odor.

In a severely advanced stage, the plate is significantly deformed and there is a small part of it, which is located near the bed.

It is quite difficult to treat nail psoriasis with such pathological changes and requires the use of a large number of different methods.

Damage to the plates on the legs

Psoriasis of the toenails is characterized by the appearance of a striped pattern, grooves, thickening in the plate, and in advanced cases they even fester. Similar changes can be observed with psoriatic lesions of the fingernails, but this can rather be considered an exception to the rule.

Subungual hemorrhages

Nail psoriasis is a form of subungual hemorrhage that can be of two types. The first type is also called oil stain syndrome, which is manifested by the identification of spots of various sizes under the plate that are pink or bright red.

Pathogenesis

The basis of the pathogenetic process in psoriasis lies in two processes:

Proliferation disorder.
Pathological differentiation of cells.

This starts the processes:

Reducing the life cycle of the cell.
Excessive cell synthesis.
Formation of thickenings and growths on the nails.

Each of these risk factors and etiological triggers becomes the start for the activation of cellular and humoral immunity.

This causes sequential processes to run:

Quantitative changes in the composition of blood immunoglobulins.
Transformation of the composition and content of immune complexes.
Increased activity of lymphocytes, segmented leukocytes.
Activation of the complement system.
Development of reactions against one's own cells through the production of antibodies.
Excessive synthesis of inflammatory markers by the stratum corneum.
Impregnation of the epidermal layer with T-lymphocytes.
Stimulation of increased proliferation of skin cells.
The development of uncontrolled growth and division of the cellular composition of the stratum corneum of the skin.

The process constantly goes through all stages, creating a vicious circle, which only negatively affects the course of the disease.

Therapy methods

Treatment of nail psoriasis is a long and rather difficult process; throughout the entire period, the patient must make efforts to achieve a positive therapeutic effect and use various drugs or combinations thereof to alleviate the disease or cure it.

In this case, it is necessary to follow the rules of nail care at home:

cut short;
try not to injure them;
Manicures, pedicures and other cosmetic procedures on hands and feet are prohibited;
Wear gloves when performing household chores.

Treatment of psoriasis on the fingernails and toenails involves taking vitamins and multivitamin complexes with minerals.

Fat-soluble vitamins include A, D, E and K. There are dosage forms for oral administration and injection.

Ensuring sufficient levels of vitamin D leads to more successful treatment of the disease.

It strengthens cell walls, normalizes the exchange of phosphorus and calcium, and stimulates skin regeneration. Also, the optimal level increases the efficiency of ultraviolet radiation.

Additional administration of vitamins A and E slows down the proliferative growth of tissues and the rate of keratinization of the upper layer of the epidermis. Since the nail plate is a derivative of the skin, there is an improvement in the condition of the nail plates.

Water-soluble vitamins include: groups B and C. These vitamins are prescribed for complex treatment. Their appointment helps to normalize metabolism in the body and stabilize the course of the disease.

In case of mild nail psoriasis, sometimes it is enough to use medicinal varnishes, which slow down the progression of the spread of the pathological process and prevent exacerbation from developing during the period of remission; treatment with folk remedies is effective.

To treat severe nail psoriasis, topical medications are prescribed: ointments, creams, lotions, sprays, gels, solutions, which are best applied at home. They can be hormonal and non-hormonal.

Hormonal agents contain glucocorticosteroids, which, penetrating to the lesion, promote rapid regression of pathological changes, but they are not recommended for long-term use due to the high risk of side effects:

They are used to relieve acute symptoms, but not for more than 7-10 days. Then non-hormonal ointments are prescribed to consolidate the effect obtained:

In mild cases, non-hormonal drugs and vitamins can be used for treatment. You can treat nail psoriasis with Chinese ointments, for example, skin king - it is also effective in combating the disease.

If necessary, antihistamines, antidepressants and a therapeutic diet are prescribed. Nail psoriasis, minimum duration of therapy is 3 months.

In case of a complicated course of this form of psoriasis, the patient may be prescribed desensitizing therapy, adsorbents, hormonal drugs for oral administration, cytostatics, and immunomodulators. When an infection occurs, use antibacterial drugs.

To carry out treatment at home, you can use folk remedies.

To prevent the progression of destruction of the plate, baths based on decoctions of various medicinal plants, for example, chamomile, celandine, and calendula are recommended.

At night, you can apply medicated oils to diseased areas of the skin, for example, olive, burdock, litho oil or combinations thereof.

With their help, you can make various ointments with your own hands. When treated with folk remedies, psoriasis on the nails can be cured in the early stages of development and in mild cases. You can take medicinal infusions, decoctions and mixtures internally.

Medicinal monastery tea is also effective for psoriasis, and it also helps restore the body’s defenses and cleanse it of accumulated harmful compounds.

And also strictly follow the recommendations given by the doctor and do not take prescribed medications for the treatment of pathology.

It is not always possible to completely cure nail psoriasis, but the chances of achieving long-term remission are high only if treatment recommendations are fully followed. Yes, the treatment is long, labor-intensive and expensive, but the result is worth it. And treatment with folk remedies can help with this.

If you violate the instructions and do not carry out treatment procedures at home, then due to a violation of the protective properties of the plates, a bacterial and fungal infection may join the existing disease, which will aggravate the course of psoriasis.

The use of folk remedies

Treatment of psoriasis at home often includes the use of traditional medicine recipes:

Lotions are made - 0.5 liters of water is mixed with 2 tbsp. l. corn starch and 2 tbsp. l. oatmeal
Applying compresses - 4 tbsp. l. cocklebur herb is brewed in 0.5 liters of boiling water. The grass is applied to the affected areas, wrapped in film and left for a quarter of an hour.

When identifying symptoms of the disease, it is important not to self-medicate, but to consult a dermatologist so as not to aggravate the course of the disease.

Useful tips

They will help alleviate your condition and quickly get rid of the symptoms of the disease:

Play sports, strengthen your immune system;
Try to avoid cuts, wounds, and skin lesions, which can lead to activation of psoriasis;
Be sure to take care of your nails and skin. They must not be overdried. To do this, use moisturizing creams and oils.
Do not use regular nail polish. It should only be therapeutic;
Cleaning the apartment should only be done with gloves;
Cut your nails short, do not allow hangnails to lift;
Do not get your manicure done in unverified salons.

Diet for nail psoriasis

An important condition for the success of therapeutic treatment is diet. Few people know that allergies can be present with any type of psoriasis. Therefore, a hypoallergenic diet should be followed.

The patient's diet must be balanced, excluding foods that can provoke allergies (chocolate, coffee, cocoa, strawberries, citrus fruits). The diet prohibits the intake of spicy, salty, fatty, smoked and fried foods. In addition, mustard, mayonnaise and ketchup should not be used.

During an exacerbation of psoriasis, the diet involves fasting monodays, i.e. You can only eat one food item during the day, for example, kefir, apples, boiled fish, etc. The diet should be rich in fermented milk products, fresh vegetables and fruits (excluding all orange and red ones), as well as fish and herbs. To replenish the body with lecithin, it is recommended to use vegetable oil (better than virgin olive oil). It is important to remember that any diet excludes the consumption of alcohol, regardless of the form of psoriatic manifestations.

Varnishes for nail psoriasis

If psoriasis is a mild form, then medications will not be required at all. Therapeutic varnishes for psoriasis (Belvedere, Clobetasol, Nail Tek Xtra, Blaze Nail Force) will help cope with the problem They will hide external defects and prevent recurrence of the disease. It is necessary to apply medicated nail polish for 3 or more months.

A drug for treating nails, Frenchi, has also been created, which resembles gel polish. It is completely colorless. The affected nail needs to be coated with gel polish daily, and it is washed off with a special liquid weekly.

Each nail polish for nail psoriasis contains microelements and vitamins. Also, these varnishes can treat psoriasis on toenails, after first carrying out hygiene procedures.

The drugs in the varnish penetrate deep into the plate, providing treatment for psoriasis under the nails. Regular use of the product will solve almost any nail problem.