Nail pitting is seen with ?
**Core Concept**
Nail pitting is a clinical sign characterized by small depressions or dents on the surface of the nails, often associated with underlying systemic or dermatological conditions. This phenomenon is typically observed in conditions that affect the nail matrix or plate.
**Why the Correct Answer is Right**
The correct answer is associated with psoriasis, a chronic inflammatory skin condition. In psoriasis, the nail matrix is affected, leading to abnormal keratinization and subsequent nail pitting. The nail matrix produces the keratin protein that gives structure to the nail plate. In psoriasis, the abnormal keratinization process results in nail pitting, a classic sign of the disease.
**Why Each Wrong Option is Incorrect**
**Option A:** This option is incorrect because nail pitting is not a characteristic feature of alopecia areata, which primarily affects hair follicles.
**Option B:** This option is incorrect because nail pitting is not typically associated with eczema (atopic dermatitis), which primarily affects the skin's barrier function and immune response.
**Option C:** This option is incorrect because nail pitting is not a common feature of fungal infections, which typically cause nail thickening, discoloration, or brittleness.
**Clinical Pearl / High-Yield Fact**
In addition to nail pitting, psoriasis can also cause other nail abnormalities, such as onycholysis (separation of the nail from the nail bed), subungual hyperkeratosis (thickening of the nail plate), and nail thickening.
**Correct Answer: B. Psoriasis.**