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    Old 08-14-2005, 06:39 PM   #1
    cowboy ray
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    Please help identify this problem

    Ok, here's the deal. About 7 years ago I developed a problem with my fingernails, though I really don't recall the time frame for the breakout. There is some pitting (from needle-head, to sharpened pencil tip in size, I'd say) as well as a general, but not too severe, roughness to them (with the appearance of small, contained, white "flake-ish" patches that are just on the surface of the nail). Also, the nail bed appears to be a bit discolored (it's a bit more rosy than they should be and the cuticle area underneath is kinda off-whitish). As far as I can recall they used to look a bit worse than they do now. A couple of my nails had a thick spongey appearance, towards the outside tip...now it's just the pitting/flake-ish appearnace. There is one exception however that is bothering me to no end. One of my thumbnails has gotten worse for some reason. It's got the same pitting, and white "flecks" as the rest...but the shape is deformed.

    Crappy illustration:

    _____
    | \
    |==----)
    |_____/


    The left side is the cuticle. The "="'s represent where there is a raised bulge about 1/8" tall (and about 1/4" wide) of the nail plate (it's only in the center, just how I have it illustrated, though it seems the rest of the nail kinda slopes to form the ridge). I don't think it's just a thickening of the nail, though it is slightly...just more that it's raised above the nail bed, since if you push down on it it seems to be kinda hollow under there. Then right where the bulge goes back down to the level of the nail bed, it starts to split clear to the edge of the nail. It's not a complete split per se, but sort of a crack in the nail where there is only some kind of bottom layer of enamel remaining above the nail bed itself though there probably is a fine crack running through that. Now, here's the weird part that I can't understand for the life of me. About once every 2 weeks, I use one of those nail buffers (the white rectangular blocks) to smooth out the surface of my nails. When I do this, they actually look just about normal and smooth, except for the thumb. But within 1-2 weeks time, the pitting and roughness re-appears on the surface of the nail THAT IS ALREADY GROWN OUT. So basically, they're not just growing out like that, but it's forming on the nail itself. I just saw a dermatologist, and he couldn't even understand it. All he could really say was that it was atrophy of the nail/matrix/bed or whatever. I've looked up pictures of nail atrophy, and it doesn't look like what I have at all. Plus my nails are regular size and shape. I should also note that I've got similar pitting on my 2 big toe nails, but none other. I know this is a long read, but if someone could please help me out I'd appreciate it.

    Oh and also, is doing the nail buffing thing a bad idea? The only potential problem that I can see with it is the thinning of the nails that can occur. I'm especially concerned about buffing the thumbnail since it seems to be thinned out in some spots.

     
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    Old 08-14-2005, 06:56 PM   #2
    Marti
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    Re: Please help identify this problem

    What you are describing is called Nail Psoriasis. It is characerized by tiny depressions in the nail plate which can also make it dry and flaky. The ridge is just a raised rail that the nail plate grows forward on which, due to the psoriasis, has allowed the nail plate cells to separate in this area rather than grow forward as one unit.

    Your doctor couldn't tell you what it was because most Doctors do not know about or understand nail diseases or disorders. I would contact a dermatologist who knows and understands nail diseases and disorders because it can also affect the skin on other areas of your body. there is no known treatment that will totally get rid of it in your nails, or your skin for that matter, but there are medications that will help.

     
    Old 08-14-2005, 09:47 PM   #3
    cowboy ray
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    Re: Please help identify this problem

    Well I did go to see a dermatologist...2, actually. The first one said it was lichen planus. The one I just saw said it was the atrophy. I just want to know for sure what it is. So that's a characteristic of nail psoriasis? The fact that the pitting forms and reforms within a matter of weeks on the nail plate which has already grown out several millimeters or more?

    Like I was saying though, I'm only really having a problem with the 1 thumbnail...all the other ones are pretty easy to manage and keep looking good. Is there NOTHING I can do, radical or otherwise, to make it more sightly?

     
    Old 08-15-2005, 06:34 AM   #4
    Marti
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    Re: Please help identify this problem

    Look up Nail Psoriasis on the internet to see a picture of what it actually looks like. Atrophy usually prevents the nail plate cells from forming in the first place, and the ones that it has already produced usually begin to peel and flake off. The end result with atrophy is that you will end up not having any nails at all, or what does appear will peel and flake off. Lichen Planus is ringworm of the nails and if that is what you had, he should have prescribed medication for it. YOu might want to look that up on the internet as well.

    Doctors amaze me! They spend all that time in school and they end up not knowing anything about nails even though they are a vital part of our bodies.

     
    Old 08-15-2005, 02:29 PM   #5
    cowboy ray
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    Re: Please help identify this problem

    Ok so I looked up some pics of nail psoriasis, and that seems to most closely resemble what I have, out of all the other pics I've seen...I'm guessing that's it then. What amazes me that I've wasted money on 2 dermatologists, both of whom seem to have misdiagnosed me...and I end up getting a correct diagnosis for free from the internet o_O.

    The only thing that doesn't quite make sense to me though, is like I said before: "The fact that the pitting forms and reforms within a matter of weeks (days, really) on the nail plate WHICH HAS ALREADY GROWN OUT several millimeters or more". When I say re-form, it's because I buff them to a smooth state and then they re-pit...not just grow out pitted. From what I read about nail psoriasis, the cause of the pitting is within the nail matrix so this doesn't really make sense to me! Have you ever heard of this before?

     
    Old 08-16-2005, 06:46 AM   #6
    Marti
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    Re: Please help identify this problem

    Since you buff off the pitted portion and the nail bed underneath is already compromised, yes, it can "re-form" on the surface of the nail plate. the psoriasis forms in the matrix, but since the matrix is a part of the entire nail unit, the entire nail unit will be compromised wheteher you buff them smooth or not.

    You also might try applying some essential oil to the nailplate several times a day to help prevent the crumbling and peeling associated with nail psoriasis. Try Botamical Oil which is available in the nali department of your local Sally Beauty Supply. Botanical oil contains jojoba oil and other essential oils that will help to condition and moisturize the nail plate.

    There are several message boards associated with persons with nail psoriasis. You ight try looking for one of them and asking questions of those people.

     
    Old 08-16-2005, 07:59 PM   #7
    cowboy ray
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    Re: Please help identify this problem

    Ok, I'll do that...thank you *so* much for your help, marti.

     
    Old 08-25-2005, 09:06 PM   #8
    cowboy ray
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    Re: Please help identify this problem

    Just one more thing...based on everything that I've told you, how sure are you that what I have is nail psoriasis?

     
    Old 08-26-2005, 06:27 AM   #9
    Marti
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    Re: Please help identify this problem

    Quote:
    Originally Posted by cowboy ray
    Just one more thing...based on everything that I've told you, how sure are you that what I have is nail psoriasis?
    Pitting of the nail plate, peeling and crumbling are classic signs of nail psoriasis.

     
    Old 08-26-2005, 04:15 PM   #10
    cowboy ray
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    Re: Please help identify this problem

    Ok I lied, just 1 more question

    As I said, I only have 1 fingernail that I would consider to be deformed...the rest are really not nearly as bad. Dealing with it as it is is bad enough, but I'm doing my best. My worst fear, however, is that any more of my nails will split or become raised off the nail bed. If that were to happen I REALLY don't know what I would do Do you think that if that was the case, that I would have seen it by now (about 7 years of symptoms)? Or could it happen anytime within the rest of my life?

    Is there anything I can do to minimize the chances of that happening? And is what I'm doing (occasionally buffing) bad for them? I don't wanna have a pity party here, but I'm only 21 and have been dealing with this for about as long as I can remember and it really sucks.Thanks again...

     
    Old 08-29-2005, 07:18 AM   #11
    Marti
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    Re: Please help identify this problem

    Quote:
    Originally Posted by cowboy ray
    Ok I lied, just 1 more question

    As I said, I only have 1 fingernail that I would consider to be deformed...the rest are really not nearly as bad. Dealing with it as it is is bad enough, but I'm doing my best. My worst fear, however, is that any more of my nails will split or become raised off the nail bed. If that were to happen I REALLY don't know what I would do Do you think that if that was the case, that I would have seen it by now (about 7 years of symptoms)? Or could it happen anytime within the rest of my life?

    Is there anything I can do to minimize the chances of that happening? And is what I'm doing (occasionally buffing) bad for them? I don't wanna have a pity party here, but I'm only 21 and have been dealing with this for about as long as I can remember and it really sucks.Thanks again...
    Nail psoriasis can begin with only one nail, and will eventually effect all 10 fingernails and/or toenails. There is really nothing you can do to stop this from happening. Psoriasis can effect the nails and/or the skin. I would go back to your dermatologist or find another one that understands nail disorders and knows how to treat them. ANY change in the nail plate is cause for concern as the nails will reflect other internal disorders as well. Also, have them check for the possibility of infection from bacteria or fungal spores for the cause of the nail plate separation. The nail plate can also separate from the nail bed due to thyroid problems so please ask your regular doctor if theat might be a possibility. It's just a simple blood test to determine thyroid problems.

     
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