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To the Editor.—
Some observations regarding psoriasis are submitted. It is hoped that a conscious and deliberate emphasis on these minor points will add considerable extra help in eliciting some well known signs in psoriasis.
It is probable that almost every patient with psoriasis has nail involvement at some time during the course of his disease. Nail pitting is possibly the most common nail change and at times the earliest sign. Pitting could be due to an intermittent defect in the matrix or retention of nuclei in the keratin and their subsequent expulsion.
It is noted that this pitting of the nails in psoriasis is better detected and observed by direct light thrown perpendicularly on the nail plate. It is felt that without this procedure some of the early minimal pitting would be missed. This point needs emphasis, because normally in most of the situations in dermatology tangential and