Difference Between Fungal Nail Infections and Nail Psoriasis

Fungal Nail or Nail Psoriasis?

How Nail Pros Can Spot the Difference between Fungal Nail and Nail Bệnh vẩy nến… and when to Refer

Như một thợ làm móng chuyên nghiệp, your clients trust you to notice changes in their nails, and you’re often the first to spot signs of something unusual. Two of the most commonly confused conditions are fungal nail infections and nail psoriasis. Both can cause discolouration, thickening, and flaky nail surfaces, but they require very different approaches.

Knowing what to look for and when to refer to a bác sĩ chân can make a big difference to your clients’ nail health.

What Is a Fungal Nail Infection?

A fungal nail infection (also known as bệnh nấm móng) is caused by a buildup of dermatophyte mould fungi that invade the tấm móng tay, the skin underneath it (the giường móng tay) or any or all of the skin of the foot itself. These organisms thrive in warm, moist environments and often begin by infecting the skin between the toes (athlete’s foot) before spreading to the toenails.

Fig D1 & Fig D2: Looks like Psoriasis – It was tested and it’s a fungal infection but in this case, it could also be Psoriatic!

Fungal infections are contagious and can spread through shared footwear, nail tools, or damp environments like swimming pools, gyms and even your shower at home. Although a fungal infection can affect one or multiple nails, it may slowly worsen over time without treatment. You don’t have to be old to get one as fungal infections are often seen in young footballers or runners, the reason for this is damage to the đơn vị đóng đinh during running or playing, generally mini trauma of some kind giving fungi a chance to root but even footwear that is too small can cause an opening in a nail plate that the fungi can make its home.

What Is Nail Psoriasis?

Psoriasis is a long-term inflammatory skin condition that can also affect any or all parts of the nailS. In nail psoriasis, the hệ miễn dịch speeds up the production of skin cells around and under the nail, leading to a build-up of cells and abnormal nail growth.

Nail psoriasis is not contagious, but it can be distressing and may lead to discomfort or changes in nail appearance. It may affect just the nails or be part of wider symptoms of psoriasis on the skin or even in the joints (psoriatic viêm khớp).

What Fungal Nail Infections Look Like

Fungal nail infections usually begin at the tip or side of the nail and slowly spread.

Common signs:

• Yellow, brown, or white discolouration
• Crumbly or brittle nail edges
• Thickened nails
• Nail lifting from the nail bed (bong móng)
• Flaky debris under the nail
• A musty or unpleasant smell

Often linked to:

• Chấn thương móng tay
• Wearing tight, non-breathable and or badly fitting footwear
• Athlete’s foot (tinea pedis)
• Walking barefoot in communal areas
• Sharing nail tools

What Nail Psoriasis Looks Like

Nail psoriasis can affect all or separate parts of the ma trận móng tay (which hình thức the nail plate) or the nail bed (beneath the nail). It can appear even if the client doesn’t have visible psoriasis on the skin.

Common signs:

• Small pits (tiny dents) in the nail plate
• A salmon-pink “oil drop” patch under the nail
• Ridges or grooves running along the nail
• Thickened skin under the nail (subungual hyperkeratosis)
• White patches or splinter haemorrhages
• Nails nâng from the nail bed, often across multiple nails

Psoriatic nail changes are often symmetrical and may affect one or multiple nails at once.

Why It Matters

These two conditions can look very similar, but the causes and treatments are completely different. It’s impossible to diagnose either with just the eye – Fungal infections can only be properly diagnosed with a test – Psoriasis needs to be diagnosed by a Bác sĩ da liễu.

Treating a fungal nail with antifungal won’t help if the problem is actually psoriasis. Likewise, treating nail psoriasis with topical steroids or an antifungal product won’t touch a fungal infection.

That’s why it’s essential to refer clients to a podiatrist if you see any persistent changes or signs of infection.
***Testing can exclude or confirm a fungal infection.

When to Refer Your Client

Refer to a podiatrist if your client has:

• Pain, swelling, bleeding, or tenderness around the nail
• Nails that smell bad or appear infected
• Symptoms that aren’t improving after self-treatment
• Changes in multiple nails, especially if they look symmetrical
• A personal or family history of psoriasis or skin conditions
• Any unusual or concerning changes you’re unsure about

A podiatrist can take a nail sample, test for fungal infection, and make a clear diagnosis. They’ll also create a treatment plan tailored to your client’s needs.

How You Can Help

You’re not expected to diagnose, but you là in the perfect position to notice early changes. Your trained eye, paired with good hygiene and proper referrals, plays a huge role in protecting your client’s well-being.

By referring to a podiatrist when something doesn’t seem right, you’re giving your clients the best care possible and helping them get the treatment they need sooner rather than later.

Final Thought

Nail health is about more than just looks. Whether it’s nấm or psoriasis, catching it early can prevent long-term damage and give your client peace of mind. If something doesn’t look right, trust your instincts and refer to a podiatrist. You could be the first person to make a real difference in their health journey.

*** 1.Tsunemi Y, Takehara K, Miura Y, Nakagami G, Sanada H, Kawashima M. Screening for tinea unguium by Dermatophyte Test Strip. Br J Dermatol. 2014;170(2):328-31.