Questions in The Dermatology Forum are being answered by Dr. A. Rockoff, a board certified dermatologist, affiliated with Tufts University School of Medicine.


Subject: Nail Deformaties
Topic Area: Psoriasis
Forum: The Dermatology Forum

Question Posted By: DeeDee1 on Friday, March 30, 2001



Doctor,

I had a toenail removed about one month ago and had assumed it was ingrown. From the middle of the nail to the tip, it was very thick and had curled under to the point of each side touching each other. About the same time the toenail was removed, I noticed my thumbnail was looking strange as well. It didn't hurt and looked as if I had smashed it. Then about a week ago I noticed my other thumbnail was looking deformed. A few days ago I woke up in the middle of the night with both my thumbs and index fingers hurting very badly. They were throbbing and felt like they were burning. I showed my doctor and he said he has never seen this but is running blood tests and did xrays to rule out rheumatoid arthritis. He said he'd test for psoriasis even though I don't have any skin problems.I am in a great deal of pain. Both my thumbs and four toenails are now deformed. They look normal from the cuticle to about half way up and then they start to narrow and curl under and at the tip of the digits, they are almost touching underneath. They are very thick and discolored slightly grayish. My doctor said it's not a fungal infection and hopes he finds something in my blood that will tell what is causing this. Also, I have a lot of joint pain in my thumbs, index fingers, toes, elbows and wrists. This is all started about the same time as my nails. Any idea what this could be? By the way I'm a 35 year old female, healthy except for a neurogenic bladder of unknown etiology. Thanks in advance for any help.

Answer Posted By: Derm-M.D.-ASR on Sunday, April 01, 2001
Please forgive me, but your description does not remind me of any nail disease with which I am familiar. Sudden onset of painful, deformed nails, in the absence of trauma, is something I have not seen. Hopefully, your doctor can come up with something. If not, consultation with a dermatologist or rheumatologist (arthiritis specialist) may be useful.

Best.

Dr. Rockoff
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