In this issue, Joana Weingärtner, podiatrist and head of the GEHWOL Academy, describes the special form of nail psoriasis. The problems start with the diagnosis, and even doctors are often in the dark.
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According to a study at Saarland University Hospital, the error rate in diagnosing nail diseases was around 54 percent. One reason could lie in medical training. Nail diseases play a comparatively minor role here. This also continues in everyday clinical practice. There are also factors such as time pressure on the doctor, inaccurate statements by the patient and a lack of routine. There is also a risk of confusion. Nail fungus (onychomycosis) has similar symptoms such as white or yellow discoloration of the nails, thickening of the nail plates and structural changes in the nail material. Such commonalities make a purely visual finding almost impossible. In case of suspicion, a detailed anamnesis of the affected person or interdisciplinary work with laboratories that can, for example, perform a biopsy is helpful. Assumptions that psoriasis weakens the skin and nail barrier and thus makes them more susceptible to mycoses have not been confirmed in the evaluation of almost 5000 inpatients at Kiel University Dermatology Clinic. Accordingly, they can not only occur together, but can also be treated jointly, for example with suitable preparations.
Since psoriasis is an autoimmune disease, there is no cure. Only the symptoms can be treated with the help of local, systemic or physical therapies. For the patients, one thing counts above all: To find the therapy that reduces concomitant symptoms and thus increases quality of life. The patient‘s compliance plays a decisive role. As a foot care professional, you can alleviate the physical stress that often accompanies this. Removing excess keratinized tissue relieves pressure from the nail bed.
In addition, the risk of further pressure points and other injuries, such as catching on something, is reduced. This makes it possible to roll in the shoe without pain, improving patient quality of life. If the nail plate is largely unstable or detached from the nail bed, a nail prosthesis is recommended.
Help from the foot care professional
Those affected can also do something themselves!
During treatment, it is recommended to remove crosswise grooves and loosened tissue materials. GEHWOL Nail Compound has proven its worth for building up the damaged nail. It smooths the nail and prevents nail fungus. Building up the nail contributes to an improved appearance and restores self-confidence. The compound also protects sensitive areas of the exposed nail bed. But you can support the patient with more than temporary treatments. Encouraging regular maintenance helps to ensure an attractive appearance. This is important because treatments are lengthy and may be accompanied by relapses (eruptive recurrences). Optimal care at home also ensures improved nail elasticity and stability. GEHWOL med Nail and Skin Protection Oil is suitable for this purpose. Affected nail areas should also be kept short by filing
FUSSPFLEGE AKTUELL, The magazine for the practice, Issue 1 / 2022