I have pustular psoriasis on my both my palms and I also have Acrodermatitis (a sub-category of psoriasis). The Acrodermatitis affects all my fingertips and all of my fingernails. Right now all the ends of my fingers are raw and most of my fingernails have come away from the nail bed. So basically my palms, fingers and nails are a mess and I can't do anything that involves manual dexterity most of the time. There are times when I need help to dress, shower, hold/carry/lift things. There are times I can't even open the fridge door. And this is it. For the rest of my life.