Have any of you suffered with sever nail psoriasis? Mine only started when I began the Remicade Infusion and not only is it painful, it is really embarrassing. Comments anyone?
Thanks.
Well yes! A large percentage of PsA patients have nail manifestations. Mine looked like fungus, and then my fingernails got tender and started to lift from their beds. And then the pitting and ridging …
My nails have improved since starting Enbrel, though. But I know some people get a burst of psoriasis when they start a biologic.
I think part of why my psoriatic toenails have been so painful in the past is that they got reallly hard and curved to where they were digging into my toes (which were sausage like.) I had one cut like they do for ingrown toe nails and that has helped one toe, the other toenail lifted to where its barely attached and not digging in anymore. Now that I have started Cimzia they are clearing up and appear to be growing out normally. And yes, they can be less than fantastic to look at. It takes FOREVER to grow out and they barely grow at all when your toes are swollen.
Thank you both for your input. I had psoriasis on my toes, only minimal though and none on my fingers when on Enbrel and/or Humira. Unfortunately I had to finally go on state disability and then to Medicare (USA) 2 years after and I have a supplemental insurance now and no longer private. Neither Medicare or the supplemental(any of them and believe me I checked) cover home injections for anything unless you are a diabetic and use insulin. After researching Cimza, I saw it is also an injectable. Remicade infusion is covered and the government would rather pay for me to have this every 6 weeks at a cost of $13,000.00 ! The only way my supplement would kick in for say, Humira, is if I paid the co-pay of $800.00 per month. I can honestly blame our government and the drug companies/insurance companies for the deformities in my hands that have rapidly increase since I have been on Remicade as well as the nail psoriasis.
My dermatologist told me the nail beds are so damaged that the possibility of nails growing back are nil.
I would love to hear from people on Medicare and a supplemental insurance who have the same problem with injectable.
Thanks everyone.
I am not on Medicaid but my insurance will pay for either Remicade or injectables. I use to inject Enbrel and Humiria and Simponi myself until they stopped working for me, Now I go to the hospital for Remicade infusions every 6 weeks. I inject myself in my stomach which is easy even with deformed hands. Has your doctor or nurse tried teaching you how to inject yourself? It is not nearly as hard as it looks and the needles are so tiny these days.
None of the biologics I've been on, Humira, Enbrel, and now Simponi have helped with my psoriasis. So I continue using the topical that I have for years - Dovonex. It helps on my nails as well.
I have severe fingernail and toenail psoriasis. It is very embarrassing. It has just gotten to the point where I cannot where open toed shoes because my toes are such a mess. My big toe on my right foot is so swollen and the nail is so thick and cutting into my skin - I feel like it's going to fall off. I don't know what to do about it.
Hi Deb,
I had the same issues. Of my big toenails eventually started to lift and then got a fungal infection, I had to have it removed and am currently waiting for it to grow back. The other one has had to have the ingrown toenail surgery where the side of the nail was removed (permanently) because it was digging into the side of my toe and causing pain and pus to form in addition to the swelling. Since starting Cimzia, I think the nails are starting to clear and the swelling has gone away, but growing out the nails will be a very long process according to my podiatrist. I always love open toes shoes in the summer, I am going to wear them anyway and paint the other toenails and cover the missing one with a band-aid. I focus on it a lot because it bothers me, but I don't think other people look at our feet as much as we think they do.
Thank you, Mel! So nice to talk with someone who knows what I am going through! I thought of going to try to get a pedicure to see if they could make my nails look nice... but idk. I miss my old feet. LOL I am going to see if the Humira helps at all, and keep the Cimzia in mind as well. Thanks for the info and have a great day! :)
Mel B said:
Hi Deb,
I had the same issues. Of my big toenails eventually started to lift and then got a fungal infection, I had to have it removed and am currently waiting for it to grow back. The other one has had to have the ingrown toenail surgery where the side of the nail was removed (permanently) because it was digging into the side of my toe and causing pain and pus to form in addition to the swelling. Since starting Cimzia, I think the nails are starting to clear and the swelling has gone away, but growing out the nails will be a very long process according to my podiatrist. I always love open toes shoes in the summer, I am going to wear them anyway and paint the other toenails and cover the missing one with a band-aid. I focus on it a lot because it bothers me, but I don't think other people look at our feet as much as we think they do.
LittleDeb, absolutely, get a pedicure! You’d be surprised at what a professional pedicurist can do for those toes of yours. Be sure, though, that you educate the pedicurist that what she is looking at is NOT fungus, but psoriasis. (They really don’t like “doing” fungal nails.) Sometimes I’ll even make a point of telling them how important it is for THEM to encourage customers to see a dermatologist to confirm that what’s in the toenails is fungus or psoriasis. Because if someone had told me that I had psoriasis years ago (instead of assuming it was fungus) I might have been diagnosed with PsA, and perhaps even dodged a few joint replacements.
It’s a PsA teaching moment. By the way, my dermatologist gave me the green light for polish on psoriatic toenails. Won’t hurt 'em, and they will look pretty when they’re done. Go for it! I’ll do you good!
I have damage to one nail (right thumb). It happened about 18 years ago. They did xrays and saw nothing. It wasn't a fungus. Nothing made it better. If I hit it I go through the roof with pain. One doctor said it might be psoriasis but no one said anything else....now 18 years later and after many other issues finally a doctor diagnosed PsA. Anyway...so far no other nail issues, but, I get acrylics done every three weeks at my nail salon. Now my nails look great. It hides all the ridging!! It is pricey, but I am worth it. I gesture a lot with my hands and use them in presentations so doing this makes my ego much happier.
I have it on my right pointer finger nail. It looks like fungus and gets crumbly, is lifted from the nail bed, is super thick and has ridges in it. It used to hurt but since I got on methotrexate it stopped hurting. I paint my nails to make them look "normal". I would ware fake nails but they typically don't fit since the nail is kind of misshapen. I also have pits on the pinky nail of my left hand. Ive noticed pits and ridges forming on my other nails as well. It seems like a fairly common thing people on here have.
Acrylic nails are a powder that is melted and attached to your own nail...it will fit anything. My thumb nail is super thick with ridges, and misshape too., the acrylic makes it look smooth and pretty. Ask about it at a nail salon some time. With all of the other pain issues, swollen finger and hand joints, knees, elbows, weight gain due to lack of exercise, etc. I strive to find one area that I can feel pretty. It is worth every penny to have my nails make me feel emotionally better. Hope you can find what makes you feel better.
Not my thing obviously, but I came across this on FB. My wife just had her shop vehicle that she takes to Quilt shows wrapped, so can't imagine it wouldn't work on nails too.
Gels nails do make your nails look nicer. However, here comes Debbie Downer. If your nails are pulling from the nail bed, it might be best to avoid the gels. They can add extra weight to your nail and make you more susceptible to hanging your nails on something,and can speed the process of pulling the nail off of the bed. All of these are pretty painful. When the gel is removed, it leaves the nail incredibly weak and thinner than what was initially there. If you can get your psoriasis under control systemically, the nails will get better too. Mine look pretty fab now, but were horrible a few years ago and before bios.
Can I just agree with Grumpys Debbie downer, if the nail is coming away from the nail bed in places any sort of false nail can cause damage when they get snagged on things because of being longer than the natural nail. I was told this by an acquaintance who runs a nail bar, when I enquired about having mine done…she has seen nails detached in P patients. So it a sort of proceed with caution 
I’ve had the gels, before and during the time that my P got really bad, and when I developed plaques under my nails. When the nails started to pull away, it was really uncomfortable, and anytime I hit the nail or snagged it, O.M.G, it hurt so badly. With Humira, my skin and nails cleared really quickly, even my toenails got better. I still have some ridges in my nails, and I’m not sure that will ever go away, but they look and feel so much better. There is a Sally Hansen product called Tough as Wraps, and it goes on just like a polish. It makes your nails thicker, Less easy to break, but also will even out some of the pitting. I have used it religiously for years any it made my nails look so much better. Everyone might like to try it as it’s the best of both worlds. You get thicker nails that don’t break and chip as easily, smoother nails, but it’s not so heavy as a gel manicure. It’s under $10 for the bottle. I top it with regular polish.
Hi Erinsmum! IDK if mine is severe, but it is ugly. I keep my fingers hidden a lot. I agree--it is painful.....my fingers usually feel like they're being squeezed or crushed. I sometimes think that a few years ago when I applied fake nails is when mine started giving me more trouble. They haven't been normal since. Last year when my son got married, I had professional nails applied. I almost went nuts from the crushing feeling and couldn't wait to have them removed! For the pain, I have tried ice and heat, but those really haven't worked. I don't take meds other than OTC stuff, which doesn't do much, either. Sorry I can't help--but hopefully someone else has some suggestions!
Just an update... I first replied to this post on April 2nd. I have now had 3 injections of Humira. My fingernails have now smoothed out. They are starting to look more "normal". I can't tell much about my toenails yet, but remain hopeful. Can't tell much about my PsA either, but hopefully the Humira will help that too. I know that this may not last forever or for long, so I am enjoying while I can. :)
GrumpyCat, I bought something called Hard as Wraps... is that the same thing?