Nail Psoriasis Vs Fungus – Differences , Symptoms and When to See a Doctor?

Nail psoriasis and fungal infection are the two most common problems that people experience in their fingernails or toenails. Since the symptoms of both conditions are the same, it is important to figure out which issue you have to get the right treatment before it worsens. 

In this article, we will provide detailed information on nail psoriasis vs. fungus and help you learn how to distinguish between the two. 

What is Nail Psoriasis vs. Fungus

Problems with nails are not uncommon. While some issues can be managed by clipping the nails, others may need more comprehensive treatment. 

The common symptoms of psoriasis and fungal infection are-

• Discolored nails, usually yellow-brown or dark
• Cracking on the nails 
• Thickened nails 
• Nails separating from the nail bed

Since these symptoms are common in both, it becomes difficult to decide if it’s because of nail psoriasis or fungal infection. 

While psoriasis is an autoimmune disease, nail fungus is a result of fungal infection. Usually, psoriasis on nails occurs when the person has psoriasis on the skin. If you are a person with a light skin tone, psoriasis will appear red with scaly patches; on the contrary, among dark-skinned people, it will appear violet with gray scales. 

Even though the common symptoms of both are the same, they also differ in many aspects. 

Know the Different Symptoms Nail Psoriasis vs. Fungus

Below is a table differentiating the two based on their symptoms-

Symptom	Nail Psoriasis	Fungal Infection on Nails
Nail Surface Texture	Pitting (small pits or dents) on the nail surface	Crumbling or ragged nails
Nail Ridging	Ridged nails	Doesn’t form ridges
Nail Deformity	Yes	Slightly
Nail Separation	Nail separates, create gaps, allowing bacterial infection	Progressive distortion in nail shape
Itching	Itching is common, especially if psoriasis affects the surrounding skin	Itching is less common, but can occur if the infection spreads or irritates the surrounding skin
Pain	May or may not cause pain, usually associated with severe nail involvement	Typically painless, but discomfort can occur if the infection spreads or causes nail damage
Odour	Odourless	Foul odour

Since psoriasis is an autoimmune disease, it is not as prevalent as nail fungus. Fungal infections are contagious and can spread to others easily. At the same time, when it occurs, the chances of spreading between the toes and onto the skin of the feet are also observed. In severe cases, it causes tines pedis or athlete’s foot. 

If you observe foul odor along with other symptoms, there are higher chances that it is a fungal infection. 

Nail psoriasis is more typical among people with skin psoriasis. 

Below is a differentiation between nail psoriasis and fungal infection in different aspects. Check it out!

Aspect	Nail Psoriasis	Fungal Infection on Nails
Cause	An autoimmune disorder causing overactive immune system, leading to inflammation in the skin and nails	Caused by fungal growth, typically dermatophytes, in or around the nails
Spread	Does not spread from person to person, but may affect multiple nails and other areas of the body	Can spread from person to person and to other nails or skin areas through direct contact
Treatment	– Topical corticosteroids – Vitamin D analogues – Topical retinoids – Systemic medications (e.g., methotrexate, cyclosporine) – Phototherapy	– Antifungal creams or ointments (e.g., clotrimazole, terbinafine) – Oral antifungal medications (e.g., terbinafine, itraconazole) – Nail lacquers (e.g., ciclopirox) – Surgical removal of the nail in severe cases

Who Is More Susceptible to Nail Psoriasis and Nail Fungus?

As already mentioned, psoriasis is an autoimmune disease, and therefore, people with skin psoriasis have a higher chance of developing nail psoriasis. 

On the other hand, nail fungus occurs when the causal organism, fungus, finds a suitable environment around the nail to grow and flourish. A slight separation between the nail and nail bed allows the fungus to develop, especially if the condition is warm and moist. 

Often, people entering showers or pools with nail separation have a higher chance of getting the infection because fungus hides in such places. Even a microscopic cut can let them in under such situations. 

People who are more likely to get nail fungus include those with-

• high tendency to get fungal infections
• family history 
• excessive sweat 
• works where hands and feet are often wet
• poor ventilation in socks 
• came in contact with a person with fungal infection 

When to Visit a Doctor?

Usually, the mild symptoms do not require any treatment, and they resolve on their own. However, if you have skin psoriasis and are experiencing discoloration of nails, pitting, or cracking, it is advised to check it with your doctor. 

Being an autoimmune disease, treating nail psoriasis could be tricky. Most of the cases start with topical treatment, wherein the doctor may recommend-

• vitamin D ointment
• corticosteroid injections to the nail bed
• light therapy (phototherapy)
• biologics

If the condition doesn’t improve, surgical removal of the nail is advised to allow new nail growth to take its place.

For nail fungus, over-the-counter antifungal ointments work wonderfully. If the problem persists, prescription topicals and oral antifungals may be administered to treat the problem. If the nail has been damaged severely, the doctor will remove it surgically for new nail growth. 

Conclusion 

While nail fungus is a common problem, nail psoriasis is rare and found among people with skin psoriasis. Being an autoimmune disease, there are no chances to refrain from it; however, you can take certain measures to keep fungal infections at bay. 

It is important to maintain good nail hygiene and keep them dry thoroughly. If you have the tendency to get fungal infections, keeping your manicure and pedicure tools handy to clean the nails and disinfect them helps. 

At the same time, wear proper ventilated socks and shoes to prevent fungal growth. 

Feature Image Source – Canva

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