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White areas on finger nails

Posted , 6 users are following.

bob73443
bob73443

Hi all,

I've been diagnosed with PMR for about 13 months, and have been on decreasing dosages of prednisone ever since.  I started at 25 mg per day and am now down to 9 mg per day.

For several months, I've noticed that a few of my finger nails had white lines, or even areas of my nails that grew with the propagation of the nail.  Only one or two nails were affected.

But recently, I've noticed an increase.  Now, 6 of the 10 fingers have white areas on the nails and the areas are larger and larger.

I'm wondering if this related to PMR, prednisone usage, or if it a symptom of another underlying issue?

Any ideas?

THanks,

1 like, 11 replies

11 Replies

  • EileenH
    EileenH bob73443

    Posted

    It is called leukonychia (or leuconychia) - commonly called milk spots. Google it and you'll find a quite good description of the various versions with photos on wiki (wiki does some things very well!). 

    It isn't usually a sign of anything except that your nail bed is a bit delicate - bits of damage occur and then grow out through the nail. Some doctors think it reflects zinc deficiency - others don't.

    NHS link (you'll find it using your search engine) gives some rather yuk pictures with the things that do indicate something really wrong - don't look at it before lunch though unless you have a very strong stomachrolleyes

    Since you say they are getting bigger it's possibly something to run past your GP.

    Interestingly - it can be sign of nail psoriasis and there is one form of inflammatory arthritis called psoriatric arthritis. Was there ever any question about it being PMR?

    • bob73443
      bob73443 EileenH

      Posted

      Hi Eileen, and thanks for the reply.

      I actually did Google this, and even went to the link you shared before posting to this forum.  I found some things that were a bit scary when I Googled it, which is why I came to this forum.

      Seems like you, yourself have not experienced this.

      I wonder if others have?

      Thanks so much and good to "see" you again.

    • EileenH
      EileenH bob73443

      Posted

      I did in the early days of PMR with no pred. When I removed any nail varnish the toenail underneath was plain white. It slowly disappeared with pred and my toenails went back to normal - as the descriptions say, it takes a LONG time for nails to grow out. I even lost the small toenails altogether on one occasion - they seemed to have loosened while on a longish walk in proper walking shoes. 

      My finger nails were very breakable and would split in layers - again it went with pred and I had the best nails I have ever had in my life! I know quite a few people who say the same.mIt isn't as good now and in fact I had a few months where they seemed very fragile but they've improved again.

      I came to the conclusion originally that the PMR/GCA was affecting the blood flow to the nail bed and the nails simply weren't forming well due to lack of oxygen and nutrients. No reason to think otherwise.

  • judy93591
    judy93591 bob73443

    Posted

    Hi Bob, interesting to see your post.  I was diognosed in May with PMR..to long of a story to go into on my horrid journey, with flares.  But, on the fingernail issue, I also developed only 3 nails like you describe.  both thumbs and my right forfinger!  Prior to diognose, all my nails were darker pink at the base.  This is gone, but the three affected fingers, have pink half circles, not the 'moon' that is usual??? it is weird.  My nails are also very fragile, as is my skin.  I could easily donate skin for transplant, the way it will peel off at the least 'scratch' etc...like the dog..?? yesterday??? of if I scrape on the cupboard.  So, now I will have to  google the info shared on your message, while I can sit as I am never pain free.  Finally get to see Rheumy tomorrow, and have high hopes for something to aid in this battle! Judy in MI USA
  • ptolemy
    ptolemy bob73443

    Posted

    Hi Bob, out of interest are you taking vit D and calcium supplements? 
    • ptolemy
      ptolemy bob73443

      Posted

      It is just that vit D and calcium supplement is recommended with pred as pred can affect them. It is recommended you have a bone density scan too, as pred can cause bone density loss. I don't know if you had a Dexascan? 
  • lodgerUK_NE
    lodgerUK_NE bob73443

    Posted

    I was told when young that if your nails go funny, ie ridges or white spots.  It is a sing that you have an illness of some sort.  Sure enough over the years, ridges have come and gone and it has always been when I have not felt up to scratch.   However with pred, the longest strongest nails possible.   Then off pred and back to normal till March this year,  yup you guessed is ridges and splitting - discovered I have gall stones!!!!!!!!!!!!

    That is my six pennorth.

    • ptolemy
      ptolemy lodgerUK_NE

      Posted

      As a child I was always told white spots were calcium defficiency, I don't know where that idea came from and it may be rubbish.  I did read a book on how you could tell illnesses from nails. It does seem that all sorts of things can be associated with different nail abnormalities. Different nail colour tinges, purple, blue, yellow, white.... can also show certain problems apparently. 
    • lodgerUK_NE
      lodgerUK_NE

      Posted

      Meant to add a cube of jelly per day helps nails to grow and be stronger, don't ask, I worked with 400 girls at one time and we all had beautiful nails.  Old Wives tails are often truth not tails.
    • ptolemy
      ptolemy lodgerUK_NE

      Posted

      That's right I remember munching through jelly cubes. I liked blackcurrant and hated the green and yellow ones.
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