is a common autoimmune disease of the skin that is thought to affect approximately two percent of the population in the United States. Psoriasis can manifest on the skin in a variety of ways, most commonly as scaly red plaques that tend to form over the joints. However, the rash can occur anywhere on the body, and it commonly affects the nails in addition to the skin. Studies have found that anywhere from 10 to 55 percent of psoriasis patients have some involvement of the nails. Nail disease tends to be more common in patients that also have arthritis
due to their psoriasis. The exact mechanism of damage to the nails is not known, and several different forms of nail psoriasis can be seen. These changes can include the formation of "dents" as you describe, often referred to as "pitting;" this is due to the loss of cells from top surface of the nail plate. Other types of changes to the nail plate may include the formation of lines, discoloration, whitening, thickening and crumbling. Dermatologists
commonly see nail disease related to psoriasis, and can offer numerous treatments including topical steroids, steroid injections, ultraviolet light and other systemic options as well.