For about 18 months now, since my SFN worsened, ive noticed changes in my nails. My toenails have Beau's lines, horizontal ridges which make my large toenails look the surface of shells. My finger nails have the appearance of Terry's nails. A dermaologist was dismissive of this but I know what I know and see these changes with my own eyes! My GP blamed medication ive been on but I haven't been on any drugs for Rheumatoid Arthritis for 8 months now.

I wonder if small fiber neuropathy can affect the nails in this way because of changes in the small nerve fibers of the skin - anyone else find this?

I lost a toenail and I have battled issues with one fingernail. Now they tell me it's fungal, but I don't think it was initially. My toenail grew back just fine. Maybe consider a work up for psoriasis which can affect only the nails and also is associated with SFN.

Thanks - psoriasis would make a lot of sense of my other symptoms I agree but I have asked two dermatologists and they were dismissive - just said systemic illness, drugs or both. The more impressive one said it might be my circulation issues/ Raynaud's. It isn't fungal though I'm told. Mat

I carry the genotype for psoriasis but have no manifestations of it. Initially this nail appeared to be psoriasis but dead tissue does get attacked by fungus and voila, know who knows. Vasculitis also causes these types of things.

I assume you have a negative ANA?

This link explains alot about nails, and systemic disease:

http://www.aafp.org/afp/2004/0315/p1417.html

Thanks MrsD.

I am using tea tree oil right now and it works the best. That said, my nail falls off and grows back off and on and takes on a variety of appearances in between, from very ugly to not so bad.

I had my left big toenail removed, following a stubbing of it in the night, which was very bloody, painful, etc.

It grew back all flakey and ugly. I took care of the nail bed well, and used antifungal cream on it, and kept it covered. It never showed any signs of infection by fungus or bacteria. I think it is part of my neuropathy/lupus process. I think the nail bed is dying. So I understand completely.

I have biopsy confirmed case of non-length dependent small fiber neuropathy and also have Beau’s lines on several of my toes. Thought I was the only one until I read your post.

I am not sure if the lines are cause by the neuropathy or the underlying systemic condition causing the neuropathy (Behcet's/vasculitis). However, the Beau's lines didn't appear until the neuropathy started to become noticeable and the Behcet's symptoms had already been there for years before that time.

Regardless, I hope you find some peace in knowing you're not the only one with this symptom related to your struggle with neuropathy!

All the best,
SFN Warrior

I have several toe nails with Beau's line and other nasty changes. I just found out that it's likely due to what is suspected as Psoriatic Arthritis in my case. I thought my neuropathy was playing a role...and I still think it may be partially resonsible.

There are many systemic diseases that can cause nail changes. MrsD's link was quite helpful to detail the different variations and how they are related to various medical conditions.

Yes. My nails used to be smooth and long. They are brittle and have hard ridges on them all now. I noticed it started slowly on 2 nails last year and now its all of them.