Have your nailsstarted becoming thick recently? Are they turning a discolored shade of yellow or brown? It’s easy to assume one thing: There’s a fungus among your fingers. However, that’s not always the case. What you may be experiencing is, in fact, is a subtype of a chronic condition called指甲牛皮癣。Sneakyright? Though they can look like alike, there are a few signature signs to tell nail fungus and nail psoriasis apart—including this one major difference: “Nail fungus rarely occurs on the hands,” says Namita V. Joshi, M.D., of Atlantic Health System in Morristown, NJ. “I typically will see it on脚, since the feet receive less sunlight and overall exposure.,” she says.
与通常仅影响一个指甲的真菌不同，银屑病经常敲打许多指甲，包括手指and密歇根州底特律的韦恩州皮肤病学副教授兼计划主任史蒂夫·达维卢（Steve Daveluy M.D.）说，脚趾甲另一个线索是：“在指甲上生牛皮癣非常罕见，没有其他地方，因此大多数患有指甲牛皮癣的人在皮肤的其他区域都有牛皮癣，”他说。
让我们仔细研究这些指甲问题不同的其他几种方式。
破译症状
While fungus may be the first thing that comes to mind, both conditions share symptoms that are super similar. Telling the two apart visually can sometimes come down to microscopic differences. Let’s break it all down.
指甲牛皮癣
除了您会出现诸如病变和皮肤其他区域等症状之类的可能性之外，指甲本身的牛皮癣也具有一些出色的特征：
Onycholysis:这是指甲本身从皮肤上抬起的时候。“当它是由牛皮癣引起的，在白色部分之前的指甲下经常有一条红色的条纹。这类似于betway 体育是哪国的 on the skin, with a red rash and white scales on top,” Dr. Daveluy says.
点蚀：Pits are small divots or dimples on the surface of the nail. In银屑病, the pits are irregular—some are larger, some are smaller, and they are scattered on the nail.
变色：You may have yellowish spots underneath the nail that look like drops of oil, as well as red or dark brown splotches on the nail itself from the white blood cells that flood the inflamed area.
Thickening:Psoriasis can cause the skin under the tip of the nail to become thicker, just like the thick flakes that psoriasis on the skin causes.
Bruising: Thanks to splinter hemorrhages, which are tiny bruises under the nails caused by trauma like smashing your finger, red or purple streaks under the nail may appear.
Nail Fungus
Usually, you’ll experiencefungus of the nailon just one or two digits, as opposed to all five, and you’re more likely to see it one your feet and your hands. Other common symptoms of nail fungus include:
变色：指甲可以脱离，这会导致指甲的主要变色。您可能会注意到指甲下方的黄色或白色条纹和碎屑。指甲的颜色可能会变暗，指甲的形状会逐渐变形。
Thickening:这指甲以及下面的皮肤，变稠，通常会变脆而裂缝。
气味：Nail fungus is associated with a foul odor.
Additional fungus:指甲真菌的人也可能在脚皮上生长真菌。Daveluy博士说：“这可以显示为在脚趾之间剥落，脚落在脚的边缘，剥落脚底，脚上的水泡或组合。”
指甲真菌和指甲牛皮癣的原因
Though the symptoms and appearance of nail fungus and nail psoriasis are similar, their root causes couldn’t be more different. Here’s the lowdown: Nail fungus is a curable infection that happens when your skin comes into contact with fungi and gets in between your nail and the nail bed. Unlike psoriasis, nail fungus is highly contagious and can spread like wildfire. Often, nail fungus tends to hang around in warmer, moist climates. Walking barefoot in wet, public areas like locker rooms, pools, or in garden soil could lead to infection, particularly if you already have a cut or scrape.
另一方面，指甲牛皮癣是由炎症引起的慢性自身免疫性皮肤疾病。就像常规的斑块牛皮癣一样，当皮细胞经历加速营业额和/或指甲下方时，会发生指甲牛皮癣。“这有时会导致指甲下的皮肤细胞积聚，从而导致一些牛皮癣患者经常经历的疼痛或不适。在极端情况下，堆积可能会导致指甲脱离指甲床，”乔希博士说。牛皮癣会影响皮肤的任何区域 - 指甲附近的皮肤以及生长指甲的皮肤区域。“它不会影响每个人的指甲，但是当指甲受牛皮癣的影响时，它会增加牛皮癣也会攻击关节的风险psoriatic arthritis，”达维利博士说。实际上，studies指甲牛皮癣的人中有多达26％的人继续发展牛皮癣关节炎。
手到脚趾治疗
指甲牛皮癣经过许多相同的药物治疗，医生用于皮肤牛皮癣。“有时，局部用品（如面霜和药膏）会有所帮助。如果不这样做，我们使用可注射的生物药物。” Daveluy博士说。乔希博士说，关注导致牛皮癣的触发因素首先要爆发的触发因素也很重要。
指甲真菌用抗真菌药物治疗，就像抗生素，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。”
When to Talk With Your Doctor
Most people don’t have perfectly matched nails, but if one or multiple of your nails looks dramatically different from the others, you should seek medical attention. “I always recommend that if one nail doesn’t look quite right and you aren’t sure why, it makes sense to bring it to your doctor’s attention as soon as possible,” Dr. Joshi says. “When it comes to nail health, the most transient thing that happens to patients is trauma. Perhaps you closed your finger in a car door or something along those lines. However, when something starts to change and you can’t pinpoint exactly why, it is likely a good indication to seek medical attention,” she says. For the most accurate diagnosis, consider seeing a board-certified dermatologist. Together, you can get to the bottom of your nail issues and come up with a plan of action.
Psoriasis vs. Nail Fungus:Cleveland Clinic. (2022.) “The Difference Between Nail Psoriasis and Nail Fungus.”https://health.clevelandclinic.org/nail-psoriasis-vs-fungus/
指甲牛皮癣和银屑病关节炎：Reumatologia。（2017）。“指甲参与银屑病关节炎。”https://www.ncbi.nlm.nih.gov/pmc/articles/pmc5534507/
治疗指甲牛皮癣：Dermatology and Therapy。（2021）。“指甲牛皮癣：对管理有效疗法和建议的综述。”https://www.ncbi.nlm.nih.gov/pmc/articles/pmc8163925/
