Differential Diagnosis
- Single most likely diagnosis
- Psoriatic nail disease: This condition is characterized by erythema of the proximal nail fold, absence of the cuticle, thickening of the nail plate, and marked horizontal ridges, which are all consistent with the symptoms described.
- Other Likely diagnoses
- Eczematous nail disease: This condition can cause similar symptoms, including erythema and thickening of the nail plate, although the absence of the cuticle may be less pronounced.
- Lichen planus: This autoimmune disease can affect the nails, causing thickening, ridging, and erythema of the proximal nail fold, although it may also involve other areas of the body.
- Onychomycosis: Fungal infection of the nail can cause thickening and ridging, although erythema of the proximal nail fold and absence of the cuticle may be less common.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Squamous cell carcinoma: Although rare, this type of skin cancer can present with erythema and thickening of the nail plate, and is important to rule out due to its potential for metastasis.
- Melanoma: Similarly, melanoma can present with changes in the nail plate and surrounding tissue, and is critical to diagnose early due to its high mortality rate if left untreated.
- Rare diagnoses
- Darier's disease: This rare genetic disorder can cause nail changes, including thickening and ridging, although it is typically associated with other systemic symptoms.
- Yellow nail syndrome: This rare condition is characterized by thickening and ridging of the nail plate, although it is typically associated with other symptoms such as lymphedema and respiratory problems.