Nail Nail vị trí giường bệnh vẩy nến đơn vị chỉ Nail giường và tấm Onycholysis do để tách xa của hai cấu trúc tiến triển proximally Subungual tăng sừng (khi nghiêm trọng, đây là nguyên nhân có khả năng của onycholysis) điểm dầu tăng sừng xuất huyết Splinter Nail giường và hyponychium | Table 1 Clinical Manifestations of Nail Psoriasis Based on Location of Psoriatic Change in the Nail Unit Nail unit psoriasis location Nail matrix proximal involvement Nail bed mid-distal matrix Nail bed only Nail bed and plate Nail bed and hyponychium Proximal nail fold Morphology due to pathologic change Pitting deep Leukonychia Oil spots Onycholysis due to Subungual Chronic irregular Red spots in the Hyperkeratosis distal separation hyperkeratosis paronychia indentations in lunula Splinter of the two when severe Splinter the nail plate Crumbling all hemorrhages structures this is the likely hemorrhages Beau s lines Onychomadesis Trachy onychia Crumbling due to total matrix involvement for a long duration matrix progressing proximally cause of onycholysis Silvery classic plaques 224 Nandedkar-Thomas and Psoriasis of the Nails 225 Figure 2 See color insert Pitting in nail psoriasis. Source Courtesy of Maithily Nandedkar-Thomas. and splinter hemorrhages are common 15 16 . Oil spots also known as salmon patches refer to a yellow-orange discoloration due to psoriasis of the nail bed Fig. 3 17 . Leukonychia is caused by mid-matrix disease. The whitish areas are likely due to adherent foci of parakeratotic cells that cannot be dislodged. Onycholysis is a distinct phenomenon that results from separation of the nail bed from the plate Fig. 4 . The separation begins distally and progresses proximally toward the matrix. The plate appears whitish rather than yellow because air becomes trapped underneath it. It is usually surrounded by a reddish hue 10 and is distinguished from true leukonychia by location. Leukonychia is usually seen on the proximal Figure 3 See color insert Oil spot in nail psoriasis. Source Courtesy of Maithily Nandedkar-Thomas. 226 Nandedkar-Thomas and Scher Figure 4 See color insert Onycholysis in nail psoriasis. Source Courtesy of Maithily Nandedkar-Thomas. portion of the plate whereas onycholysis appears whitish distally. Splinter hemorrhages are due .
