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.

Diagnose your symptoms now!

check your overall health status
have a doctor review your case (optional)
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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 six possibilities:

Psoriasis
Psoriatic Arthritis
Rheumatoid Arthritis
Juvenile Rheumatoid Arthritis
Ankylosing Spondylitis
Alopecia

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:

highly elevated ANA levels

Heberden's nodes

black/brown fingernails

psoriasis

very deformed toenails

morning stiffness lasting hours

minor pain in cold/cool/damp weather

itchy skin

recent onset neck pain

itchy eyes

serious eye discharge

daily morning stiffness

... and more than 20 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
Ankylosing Spondylitis	95%	Confirm
Rheumatoid Arthritis	71%	Possible
Psoriatic Arthritis	25%	Unlikely
Alopecia	0%	Ruled out
Psoriasis	0%	Ruled out
Juvenile Rheumatoid 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:

Alopecia (Hair Loss)

Ankylosing Spondylitis

Juvenile Rheumatoid Arthritis

Psoriasis

Nail pitting may be an early sign of psoriasis.

Psoriatic Arthritis

Rheumatoid Arthritis