Nail Psoriasis: Or something else? Differential Diagnosis

Congenital malformations, deformities, and chromosomal abnormalities (Q00-Q99).

  • Congenital heart defects, unspecified

Respiratory system (J00-J99)

  • Asbestosis – lung disease belonging to the pneumoconioses (dust lung diseases), said to result from inhaled asbestos dust.
  • Bronchiectasis (synonym: bronchiectasis) – permanently existing irreversible saccular or cylindrical dilatation of the bronchi (medium-sized airways), which may be congenital or acquired; symptoms: chronic cough with “mouthful expectoration” (large-volume three-layered sputum: foam, mucus, and pus), fatigue, weight loss, and a reduced performance capacity
  • Chronic obstructive pulmonary disease (COPD).

Blood, blood-forming organs – immune system (D50-D90).

  • Iron deficiency anemia

Endocrine, nutritional, and metabolic diseases (E00-E90).

  • Diabetes mellitus
  • Hypoalbuminemia – albumin deficiency in the blood.
  • Wilson’s disease (copper storage disease) – autosomal recessive inherited disease in which copper metabolism in the liver is disturbed due to one or more gene mutations
  • Thyroiditis (inflammation of the thyroid gland).

Skin and subcutaneous (L00-L99)

  • Acrodermatitis continua Hallopeau – focal redness and pustules on the extremities of the fingers and toes.
  • Alopecia areata – circular hair loss; mottling of the nails, trachyonychia (“rough nails”) and onychorrhexis (“brittle nails”).
  • Atopic eczema (neurodermatitis)
  • Dystrophia unguium mediana canaliformis – hereditary nail growth disorder.
  • Eczema – skin inflammation associated with pruritus (itching) and erythema (areal redness of the skin).
  • Lichen ruber planus (nodular lichen) → lichen ruber nails.
  • Onychomycosis (nail fungus) – clinical picture: onycholysis (failure of the nail), subungual hyperkeratosis (appearance of scales below the nail plate) and yellowish discoloration of the nails.
  • Pachyonychia congenita – usually autosomal dominant inheritance with varying degrees of cornification disorders of the skin; characteristic are thickened fingernails and toenails (onychauxis) and painful keratomas (swollen thickened horny layer on the skin) on the palm of the hand due to cornification disorder.
  • Pityriasis rosea (scale florets).
  • Pityriasis rubra – chronic inflammatory keratinization disorder (including planar palmo-plantar hyperkeratoses).
  • Psoriasis (psoriasis)
  • Pustulosis palmoplantaris – disease with the appearance of pustules on the palms of the hands and feet.
  • Vitiligo (white spot disease).

Cardiovascular system (I00-I99)

  • Endocarditis (meningitis of the heart).
  • Valvular heart disease, unspecified
  • Raynaud’s disease – disease leading to functional vasoconstriction of the hands and feet.

Infectious and parasitic diseases (A00-B99).

  • Leprosy – tropical infectious disease caused by mycobacterium leprae, predominantly affecting the skin and nerves.
  • Malaria – tropical infectious disease transmitted by the Anopheles mosquito.
  • Tuberculosis (consumption)

Liver, gallbladder and bile ducts – pancreas (pancreas) (K70-K77; K80-K87).

Musculoskeletal system and connective tissue (M00-M99).

  • Dermatomyositis – chronic systemic disease belonging to the collagenoses, affecting the skin, muscles and internal organs.
  • Collagenoses – autoimmune diseases that lead to systemic involvement, mainly in connective tissue and blood vessels.
  • Bekhterev’s disease (ankylosing spondylitis) – chronic inflammatory rheumatic disease that affects exclusively the spine and its boundary joints.
  • Reactive arthritis (synonym: postinfectious arthritis / joint inflammation) – secondary disease after gastrointestinal (gastrointestinal tract concerning), urogenital (urinary and genital organs concerning) or pulmonary (lungs concerning) infections; denotes an arthritis, where pathogens in the joint (usually) can not be found (sterile synovialitis).
  • Reiter’s disease (synonyms: Reiter’s syndrome; Reiter’s disease; arthritis dysenterica; polyarthritis enterica; postenteritic arthritis; posturethritic arthritis; undifferentiated oligoarthritis; urethro-oculo-synovial syndrome; Fiessinger-Leroy syndrome; English Sexually acquired reactive arthritis (SARA)) – special form of “reactive arthritis” (see above. ); secondary disease after gastrointestinal or urogenital infections, characterized by the symptoms of Reiter’s triad; seronegative spondyloarthropathy, which is triggered especially in HLA-B27 positive persons by an intestinal or urinary tract disease with bacteria (mostly chlamydia); Can manifest as arthritis (joint inflammation), conjunctivitis (conjunctivitis), urethritis (urethritis) and partly with typical skin changes.
  • Rheumatoid arthritis (primary chronic polyarthritis).
  • Scleroderma – group of diseases belonging to the collagenoses with an unclear cause, which is associated with a connective tissue hardening of the skin and internal organs.
  • Systemic lupus erythematosus (SLE) – systemic disease affecting the skin and connective tissue of the vessels, leading to vascular inflammation (vasculitides) of numerous organs such as the heart, kidneys or brain.

Neoplasms – tumor diseases (C00-D48).

  • Bronchial carcinoma (lung cancer)
  • Malignant melanoma – black skin cancer.
  • Hodgkin’s disease – malignant disease of the lymphatic system associated mainly with lymphadenopathy (lymph node enlargement) and splenomegaly (splenomegaly).
  • Pigment cell nevus (mole).

Genitourinary system (kidneys, urinary tract – reproductive organs) (N00-N99).

  • Nephrotic syndrome – collective term for symptoms that occur in various diseases of the glomerulus (renal corpuscles); symptoms include: Proteinuria (increased excretion of protein in urine) with protein loss greater than 1 g/m²/body surface area per day; hypoproteinemia, peripheral edema due to serum hypalbuminemia of < 2.5 g/dL, hyperlipoproteinemia (dyslipidemia).
  • Renal insufficiency (kidney weakness).

Injuries, poisoning, and other consequences of external causes (S00-T98).

  • Radiatio (radiotherapy) of the hand.
  • Trauma (injury), unspecified

Medication

Environmental pollution – intoxications (poisonings).

  • Arsenic poisoning
  • Carbon monoxide poisoning
  • Thallium poisoning