Psoriasis involves macrophage release of Tumor Necrosis Factor (TNF) and subsequent destruction of the epidermis; thus, dead skin cells build up to form scaly, flaky plaques, often on the hands and feet, scalp, and places where the skin folds, such as elbows and knees.
— The nails can also be affected; the fingernails become thick and broken, with a yellowish tint.