What’s the Difference Between Nail Fungus and Nail Psoriasis?
They may look the same, but there are important differences between these two types of nail issues that you should know about.
有指甲最近开始变得厚吗？他们是在变色的黄色还是棕色的阴影？很容易假设一件事：手指中有真菌。但是，情况并非总是如此。实际上，您可能正在经历的是一种慢性病的亚型nail psoriasis.偷偷摸摸正确的？尽管它们看起来都像一样，但有一些签名的标志可以告诉指甲真菌和指甲牛皮癣，包括这一个主要区别：“指甲真菌很少出现在手上，” Namita V. Joshi，M.D.，M.D.在新泽西州莫里斯敦。“我通常会看到它the feet，由于脚少得到阳光和整体曝光。”她说。
And unlike a fungus, which usually affects just one nail,psoriasisoften strikes many nails, including the fingers和toenails, says Steve Daveluy M.D., an associate professor and program director at Wayne State Dermatology in Detroit, MI. Another clue: “It is very rare to have psoriasis on the nails and nowhere else, so most people with nail psoriasis have psoriasis on other areas of the skin,” he says.
Let’s take a closer look at a few other ways these nail issues are different.
Deciphering the Symptoms
虽然真菌可能是想到的第一件事，但两种疾病都有超级相似的症状。在视觉上告诉两者有时可能会导致微观差异。让我们将其全部分解。
Nail Psoriasis
Along with the likelihood that you will experience symptoms like lesions and scaling on other areas of your skin, psoriasis of the nails itself also has some standout features:
Onycholysy：This is when the nail itself lifts away from the skin. “When it is caused by psoriasis, there is often a streak of red under the nail right before the white portion. This resembles捕鱼大作战 在皮肤上，顶部有红皮疹和白色鳞片。”
Pitting:凹坑是指甲表面上的小祭司或酒窝。在psoriasis，凹坑是不规则的 - 有些是更大的，有些较小，它们散落在指甲上。
Discoloration:您可能在指甲下方看起来像是油的淡黄色斑点，以及从淹没发炎区域的白色血细胞上的指甲本身上的红色或深棕色斑点。
增厚：牛皮癣会导致指甲尖端下的皮肤变厚，就像牛皮癣在皮肤上的厚片一样。
瘀血：多亏了分裂出血，这些出血是在钉子上造成的指甲下的微小瘀伤，例如砸碎手指，指甲下方的红色或紫色条纹。
指甲真菌
通常，您会经历指甲真菌与全部五个数字相比，只有一两个数字，您更有可能看到它的脚和手。指甲真菌的其他常见症状包括：
Discoloration:Nails can become detached, which causes major discoloration to the nail. You might notice yellow or white streaks and debris underneath the nail. The color of the nail may darken, and the shape of the nail can progressively distort.
增厚：Thenail, as well as the skin underneath it, thickens and will often be brittle and crack.
Odor:指甲真菌与恶臭有关。
其他真菌：People with nail fungus also may have fungus growing on the skin of the feet. “This can show up as flaking between the toes, flakes around the edges of the feet, flaking on the soles of the feet, blisters on the feet, or a combination,” Dr. Daveluy says.
Causes of Nail Fungus and Nail Psoriasis
尽管指甲真菌和指甲牛皮癣的症状和外观相似，但它们的根本原因并没有什么不同。这是低点：指甲真菌是一种可治愈的感染，当您的皮肤与真菌接触并在指甲和指甲床之间发生时会发生。与牛皮癣不同，指甲真菌具有高度传染性，可以像野火一样传播。通常，指甲真菌倾向于在温暖，潮湿的气候下闲逛。在潮湿的公共区域赤脚行走，例如更衣室，游泳池或花园土壤可能会导致感染，尤其是如果您已经有切割或刮擦。
Nail psoriasis, on the other hand, is a chronic autoimmune-based skin disorder caused by inflammation. Just like regular plaque psoriasis, nail psoriasis occurs when the skin cells experience accelerated turnover on and/or under the nail. “This can sometimes result in a buildup of skin cells under the nail, causing the pain or discomfort that some patients with psoriasis often experience. In extreme cases, the buildup can result in the nail detaching from the nail bed entirely,” Dr. Joshi says. And psoriasis can affect any area of the skin—the skin near the nails as well as the area of the skin that grows the nail. “It does not affect the nails in everyone, but when the nails are affected by psoriasis, it increases the risk that the psoriasis will also attack the joints, causing银屑病关节炎,” Dr. Daveluy says. In fact,学习show up to 26% of those with nail psoriasis go on to develop psoriatic arthritis.
Hand-to-Toe Treatment
Nail psoriasis is treated with many of the same medications doctors use for skin psoriasis. “Sometimes topicals, like creams and ointments, can help. If they don't, we use injectable biologic medications,” Dr. Daveluy says. It’s also important to pay attention to the triggers that cause your psoriasis to flare up in the first place, Dr. Joshi says.
Nail fungus is treated with antifungal medications, which are likeantibiotics，但他们与真菌作斗争，而不是细菌，Daveluy博士说。“有时局部治疗（如凝胶，药抛光剂或奶油）可以起作用。他说：“通常患者需要服用口服抗真菌剂，因为局部情况很难通过指甲板，而真菌在下面。”当治疗工作时，您可以说，因为指甲的新部分看起来更好，但是耐心是游戏的名称。Daveluy博士说：“脚趾甲的生长速度大约是指甲的速度大约三分之一，因此看到改善可能需要6个月到一年或更长时间，有时会对指甲造成永久损害。”
什么时候与您的医生交谈
大多数人的指甲没有完美匹配，但是如果您的指甲看起来与其他指甲显然不同，则应寻求医疗护理。乔希博士说：“我总是建议，如果一个指甲看起来不太正确，并且不确定为什么，那么尽快将其引起医生的注意是有意义的。”“在指甲健康方面，患者发生的最短暂的事情是创伤。也许您将手指闭上了车门或那些线条。但是，当某些事情开始改变并且无法确切地指出原因时，这可能是一个很好的迹象，可以寻求医疗护理。”她说。为了获得最准确的诊断，请考虑查看董事会认证的皮肤科医生。一起，您可以解决指甲问题的底部，并提出一个行动计划。
牛皮癣与指甲真菌：克利夫兰诊所。（2022.）“指甲牛皮癣和指甲真菌之间的差异。”https://health.clevelandclinic.org/nail-psoriasis-vs-fungus/
Nail Psoriasis & Psoriatic Arthritis:Reumatologia. (2017). “Nail involvement in psoriatic arthritis.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5534507/
Treating Nail Psoriasis:皮肤病学和治疗. (2021).“Nail Psoriasis: A Review of Effective Therapies and Recommendations for Management.”https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8163925/
