Pseudo-psoriatic nail dystrophy, a form of allergic contact dermatitis (ACD) secondary to nail product use, often mimics nail changes associated with psoriasis, leading to diagnostic delays. This review focuses on identifying dystrophic nail changes, particularly those resembling pseudo-psoriatic alterations, caused by cosmetic nail products and offers diagnostic and management strategies. Among the allergens listed as culprits, triethylene glycol dimethacrylate, hydroxyethyl acrylate, and hydroxyethyl methacrylate were the most common. This poses a challenge in differentiating between ACD and psoriatic onychodystrophy. Thus, enhanced diagnostic approaches emphasizing thorough history taking and appropriate patch testing recommendations are required. This study highlights the clinical overlap while emphasizing the absence of pathognomonic features like oil drops and salmon patches in PPND. Specialized patch testing for acrylates, often missing in standard panels, is crucial for accurate diagnosis. Findings show cessation of offending products significantly improves nail appearance within 3.5 months, reducing the need for systemic psoriasis treatments. .
Slavinsky et al. (Sun,) studied this question.