Dents In Fingernails

What Causes Pitted Fingernails?

Pitted fingernails can have various causes, ranging in severity from 'worrying' to 'serious'.  Finding the true cause means ruling out or confirming each possibility – in other words, diagnosis.

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Diagnosis is usually a complex process due to the sheer number of possible causes and related symptoms.  In order to diagnose pitted fingernails, we could:

  • Research the topic
  • Find a doctor with the time
  • Use a diagnostic computer system.
The process is the same, whichever method is used.

Step 1: List all Possible Causes

We begin by identifying the disease conditions which have "pitted fingernails" as a symptom.  Here are five possibilities:
  • Alopecia
  • Ankylosing Spondylitis
  • Psoriatic Arthritis
  • Rheumatoid Arthritis
  • Psoriasis

Step 2: Build a Symptom Checklist

We then identify all possible symptoms and risk factors of each possible cause, and check the ones that apply:
brittle fingernails
slight stiff neck
low lymphocyte count
occasional unexplained fevers
cracked skin
variable duration morning stiffness
joint pain/swelling/stiffness
psoriasis
major pain in cold/cool/damp weather
rheumatoid arthritis
fatigue after slight exertion
history of deformed toenails
... and more than 10 others

Step 3: Rule Out or Confirm each Possible Cause

A differential diagnosis of your symptoms and risk factors finds the likely cause of pitted fingernails:
Cause Probability Status
Psoriasis 97% Confirm
Rheumatoid Arthritis 30% Unlikely
Alopecia 1% Ruled out
Ankylosing Spondylitis 0% Ruled out
Psoriatic Arthritis 0% Ruled out
* This is a simple example to illustrate the process

Arriving at a Correct Diagnosis

The Analyst™ is our online diagnosis tool that learns all about you through a straightforward process of multi-level questioning, providing diagnosis at the end.

If you indicate abnormal fingernails and toenails, The Analyst™ will ask further questions including this one:
Is the surface of your nails pitted with small 'dents'?
Possible responses:
→ Don't know
→ No
→ Yes
Based on your response to this question, which may indicate pitted nails, The Analyst™ will consider possibilities such as:
Psoriasis

Nail pitting may be an early sign of psoriasis.

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