Which condition often causes tiny pits or severe roughness on the nail surface?

Nail psoriasis is a condition characterized by the appearance of small pits or significant roughness on the surface of the nails. This is due to the rapid turnover of skin cells associated with psoriasis, which leads to the formation of these depressions and can affect the overall texture of the nail. The pits form as a result of the underlying inflammation caused by the autoimmune response that defines psoriasis, indicating an overactivity of the skin cells in the nail matrix.

This condition can also lead to changes in the nail plate, such as separation from the nail bed (onycholysis) or thickening of the nails. While other conditions like onychomycosis and onychia may affect the nails, they do not typically lead to the specific pitting and rough texture seen with nail psoriasis. Pyogenic granuloma, on the other hand, is characterized by the presence of a vascular lesion rather than changes to the nail surface itself.