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 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
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:

Nail pitting may be an early sign of psoriasis.

Concerned or curious about your health?  Try The Analyst™
Symptom Entry
Symptom Entry
Full Explanations
Optional Doctor Review
Review (optional)
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