|left and right index finger tips|
Wednesday, January 16, 2013
Single Nail Dystrophy
Abstract: 22 yo man with 4 month history of an abnormal nail
HPI: 22 yo man with 4 mo history of a nail dystrophy. It began with erythema and small pustules on finger tip. A few weeks later the nail started to look abnormal. No other skin lesions. This began after starting a new job at which he uses a "mouse" for many hours a day and he thought it might have traumatized his finger tip. A brother has "eczema" of the knees.
O/E: The right small finger nail is lusterless, dystrophic and for the most part separated from the nail bed. There is some mild thickening. No marked finger tip eczema at present, but mild erythema is noted.
Lab: KOH negative. Fungal Culture negative at two weeks.
Diagnosis: Nail dystrophy. Acrodermatitis continua vs. Psoriasis (probably latter)
Questions: What is your diagnosis? How would you treat this?