From the Research
The diagnosis for an autoimmune patient presenting with onychorrhexis (nail ridging) is typically related to the underlying autoimmune condition, such as psoriatic arthritis, lupus, or rheumatoid arthritis, which can cause inflammation affecting the nail matrix and disrupting normal nail growth. The most effective approach to managing nail ridging in autoimmune patients is to treat the underlying autoimmune disease with appropriate immunosuppressive medications prescribed by a rheumatologist or immunologist 1.
Some key points to consider in the diagnosis and management of onychorrhexis in autoimmune patients include:
- Conditions like psoriatic arthritis, lupus, and rheumatoid arthritis commonly cause nail changes, including ridging, due to inflammation affecting the nail matrix 2, 3.
- Treating the underlying autoimmune disease with immunosuppressive medications, such as methotrexate (starting at 7.5-15mg weekly), hydroxychloroquine (200mg twice daily), or biologics like adalimumab or etanercept for more severe cases, can help improve nail changes 4, 1.
- For symptomatic relief of the nails themselves, keeping them short, moisturizing regularly with nail oils or petroleum jelly, and avoiding harsh chemicals can be beneficial 5.
- Biotin supplements (2.5mg daily) may help strengthen nails in some patients, although the evidence for this is limited 1.
- It is essential to monitor nail changes and consult a physician promptly if they worsen or develop unusual discoloration or separation from the nail bed, as this may indicate disease progression or infection 2, 5.
Overall, the management of onychorrhexis in autoimmune patients requires a comprehensive approach that addresses the underlying autoimmune condition and provides symptomatic relief for nail changes.