Fast Five Quiz: Can You Identify Psoriatic Arthritis and Initiate the Best Treatment Practices?

Herbert S Diamond, MD; Anwar Al Hammadi, MD


July 10, 2019

Nails are involved in 80% of patients with psoriatic arthritis but only 20% of patients with uncomplicated psoriasis. Nail involvement is frequently seen at the onset, when skin and joint disease begin simultaneously.

The following changes in the nails support the diagnosis of psoriatic arthritis:

Beau lines



Oil spots

Subungual hyperkeratosis

Splinter hemorrhages

Spotted lunulae

Transverse ridging

Cracking of the free edge of the nail

Uniform nail pitting

A direct correlation exists between the number of pits and their diagnostic significance.

For more on the presentation of psoriatic arthritis, read here.


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.
Post as: