Psoriasis or nail fungal infection? How to tell

Although it is a relatively common disease, when it comes to nail fungal infections, there’s a possibility of getting a false diagnosis, one that confuses onychomycosis with nail psoriasis, two completely different pathologies.

Therefore, performing a laboratory test is essential to determine if there’s a microorganism causing an infection or not.

How can you differentiate them at plain sight? Keep reading!

Nail psoriasis

Nail psoriasis is a systemic and autoimmune disease due to a combination of genetic predisposition and environmental triggers: commonly stress and sun.

Only 5% of the population has ungueal psoriasis and affects more or less half of people with psoriasis, but it’s rather frequent – up to 80% of cases – among people with psoriatic arthritis.

Nail psoriasis can affect only one nail or every nail or toenail in a patient. Sometimes injuries are so severe that the nail can be lost entirely. Relatively often it detaches itself from the flesh and becomes soft and brittle, turning more vulnerable to fungal infections.

Difference between nail psoriasis and a Fungal nail infection

Onychomycosis or commonly known as nail fungus, in addition to odor and localized inflammation, an accurate way to differentiate ungueal psoriasis from fungal nail infection is the color of the spots that both diseases generate:

while psoriasis produces eminently whitish discoloration in tiny or more significant spots, fungus turns nails yellowish orange and brownish when the infection has advanced.

To treat onychomycosis is necessary to make a culture to detect the type of fungus (dermatophytes or candida) and the sensitivity of this for different kinds of antifungal therapy.

The Best Treatment For Nail Fungus

Combining several therapies is usually the best option: laser therapy is an excellent choice associated with topical or oral treatments.

Is recommended to use a staggered treatment. That is, start with topical medication and if there’s a recurrence, start taking oral meds.

Finally, we must redo lab test to make sure the therapy has been successful. It’s crucial that the patient knows that the nail appearance won’t be the same for a while, even though the culture comes back negative.

How to get a proper diagnose

Although differences between onychomycosis and nail psoriasis are apparently quite clear, it’s is always essential to obtain the diagnosis and treatment directly from a specialist.