I’ve had a complicated relationship with my nails all my life, but I pushed the symptoms aside with a shrug, thinking that my nails just didn’t grow. A mani/pedi outing with the girls was always just a pedicure for me and then waiting for the others to finish getting manicures or acrylic nails put on. “What’s the point?” I would say to myself. “I don’t have any nails to manicure, and they feel heavy enough as is.”
It wasn’t until my rheumatologist was inspecting my hands that I learned there was a connection between my psoriasis, psoriatic arthritis (PsA) and the condition of my nails.
The nail is composed of three main parts: the nail plate (the actual nail), the nail bed (what the nail plate rests on) and the nail matrix (where the nail is formed). The part of the nail affected will determine the symptoms that show in your nail. Pits, horizontal lines, deformity, discoloration, onycholysis (lifting of the nail plate from the nail bed), brittle nails that crumble or splinter, and thickening of the nails can all be signs that nail psoriasis is present.
Apart from my pinky fingernails, every one of my fingernails is affected by nail psoriasis in some way, shape or form. My thumbnails feel heavy and have V-shaped peaks, horizontal ridges, cuticles and hangnails that crack and bleed. My ring, middle and index fingernails are brittle, have splinter hemorrhages (tiny blood spots that appear underneath fingernails and toenails) and break in a way that reminds me of peeling away the layers of a biscuit.
My middle and index fingers and my thumbs are all affected by onycholysis. Have you ever jumped into a freezing cold body of water, and as you surfaced tried to hide the pain with a straight face in front of your friends? That is what washing my hands feels like during a flare-up of onycholysis.
Even writing a story like this one can be a challenge. My nails start to feel heavy, and my joints puff up if I’m constantly typing or texting.