What Can Cause Nail Pitting or Pitted Nails?

What is Nail Pitting or Pitted Nails?

Nail pitting or pitted nails which are seen especially on the fingernails, is the mark or pits on the exterior parts of the finger nails. These look like ice-pick like depressions on the finger nails. Nail pitting or pitted nails is developed because of the faulty growth of layers of the shallow nail plate. The symptom is very common with the patients suffering from psoriasis. About 50 percent of psoriasis patients show the condition of nail pitting or pitted nails.

What Can Cause Nail Pitting or Pitted Nails?

The nail pitting or pitted nails can also be the symptoms of conditions like alopecia areata, sarcoidosis, dermatitis, onycholysis, reiter syndrome and connective tissue disorders.

What Can Cause Nail Pitting or Pitted Nails?

  • Nail Pitting or Pitted Nails Caused Due to Psoriasis: Psoriasis is a kind of skin disorder that changes the life cycle of the cells of the skin. Because of the disease, the cells are built up rapidly on the surface of the skin. The extra cells build solid, scales like itchy red patches. These are most of the time painful. Psoriasis causes nail pitting or pitted nails.

Psoriasis is an unending chronic disorder that may in time get better only to relapse with worsening types.

  • Nail Pitting or Pitted Nails Caused Due to Alopecia Areata: Alopecia areata is a kind of acquired skin illness that can have an effect on the part of the hair bearing skin and it is characterized by restricted non-scarring areas of hair loss. It is, sometimes connected with any other internal or external health problems. Alopecia areata can cause nail pitting or pitted nails. Most frequently, the bald areas take on the growth of hair spontaneously. There is significant tendency for the disease to be inherited from the ancestors.
  • Nail Pitting or Pitted Nails Caused Due to Sarcoidosis: Sarcoidosis is a particular kind of swelling of the body tissues. Almost any body organ might be affected with it, but it sets in first in the lungs or lymph nodes. Sarcoidosis can cause nail pitting or pitted nails.

The cause of the disease is still a mystery. Its appearance and disappearance both are sudden. Most of the times it develops gradually creating fluctuating symptoms. Some symptoms persist for life.

  • Nail Pitting or Pitted Nails Caused Due to Dermatitis: Dermatitis may be a general term that describes swelling of the skin. It can have lots of causes, and occurs in numerous forms. It normally involves itchy rash on the reddened skin.

The part of the skin affected by the disease might develop crust or peel off. Atopic dermatitis (eczema), dandruff, and rashes by poison ivy are some of the examples of the dermatitis. These are caused when the skin comes with the contact with substance like poison ivy, soaps and jewelry with nickel in it etc...

  • Nail Pitting or Pitted Nails Caused Due to Nail Separation or Onycholysis: Medically Onycholysis is the separation of the nail from the nail bed. It causes appearance of white spot on the nail. The disorder can have many causes, but is especially related to fungal infection of the nail. The nail separation can have link with other nail disorders like nail pitting or pitted nails, crumbling, flaking or other damages or changes of the nail. Separation of the toenail or fingernail normally painless and might occur slowly without affecting the individual with any specific symptoms. In other instances, onycholysis can be linked with methodical conditions, that included the connective disorders of tissues or hyperthyroidism.

Nail Pitting or Pitted Nails Caused Due to Reiter Syndrome:

Reiter syndrome is a disease of systemic rheumatism. It means that it might or can affect the organs apart from the joints. It can also cause swelling in lots of areas, as well as the skin, nails, mouth, lungs, eyes, heart and kidneys.

Small dents or pits on the nail exteriors might be the indication of some of the diseases, that might include:

  • Psoriasis, a long-term condition that tends to also cause red, flaky patches of skin (10%-50% of patients with psoriasis have nail pitting or pitted nails.)
  • Eczema dermatitis, which is a long-term skin disease.
  • Reactive arthritis in which the immune system go against the joints, muscles and other parts of the body, finally infect them in a severe way.
  • Alopecia areata, patches of hair loss.

Other Causes of Nail Pitting or Pitted Nails Includes:

  • Chronic kidney disease
  • Incontinentiapigmenti (a genetic disease which upsets the nails, hair, skin and teeth.)
  • Eczematous dermatitis
  • Pemphigus (blistering autoimmune disease)
  • Skin rash ex: Lichen planus
  • Hair loss disease such as: Alopecia areata
  • Dermatomyositis
  • Pemphigus vulgaris
  • Parakeratosispustulosa

Facts About Nail Pitting or Pitted Nails

  • The human finger nails are more prone to be affected by the nail pitting or pitted nails than the toenails.
  • Detached nails with more than 20 nail pittings or pitted nails are associated with psoriatic etiology.
  • An uncommon uniform setting of the entire nail plate gives off an impression of being a developmental abnormality in its own particular right.
  • The growth of nail pitting or pitted nails is faster than the normal nails.
  • The distance between a pit and the nail fold is indicative of the length of time for which the matrix was changed by the pathology.
  • In addition to the dorsal section, a deeper depression would be suggestive of intermediary and ventral matrix involvement.
  • The time necessary for which the matrix is free to pathology corresponds directly to the span of growth of usual nail plate.
  • Nail pitting or pitted nails is rarely helpful to build a clinical case for psoriatic arthritis, if there is no other definitive markers/ symptoms.

Nail Pitting or Pitted Nails in Children

The causes of nail pitting or pitted nails are same both in children and in adults. No other specific cause has been found, except the above, for nail pitting or pitted nails.

Types or Classification of Nail Pitting or Pitted Nails

The below mentioned are the 5 different classifications or types of nail pitting or pitted nails:

  1. Irregular Nail Pitting or Pitted Nails: Mostly seen in the condition of psoriasis. Generally small (<1mm) and shallow.
  2. Geometric Nail Pitting or Pitted Nails: These are many in number and small superficial pits and are regularly scattered in a geometrical arrangement along longitudinal lines. These types of nail pitting or pitted nails are seen in alopecia areata.
  3. Coarse Nail Pitting or Pitted Nails and Cross Ridging: These pits are very irregular and are seen in eczematous dermatitis.
  4. Elkonyxis Nail Pitting or Pitted Nails: These pits are very large, seen in isotretinoin therapy, reiters disease, syphilis, after trauma, and after healing of etretinate.
  5. Rosenaus Depression Nail Pitting or Pitted Nails: A small pitted craters grow on the ring or middle and ring finger, and normally occur in the people suffering from diabetes mellitus.

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Written, Edited or Reviewed By:

, MD, FFARCSI

Last Modified On: November 25, 2015

Pain Assist Inc.

Pramod Kerkar
  Note: Information provided is not a substitute for physician, hospital or any form of medical care. Examination and Investigation is necessary for correct diagnosis.

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