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I went through the photo you sent. (attachment removed to protect patient identity). Most probably it is a fungal infection of the nail. But I want to confirm a few things before. How long it is there? Any history of trauma? Are you having high blood sugar or any other disease? Is it painful? Please answer these questions in the follow up because the short duration and more pain will be indicative of bacterial infection. For fungal of the nail, take capsule Itraconazole 200 mg twice daily after meals for seven days per month. (seven days then no dose for three weeks, then again seven days like this). Continue for three cycles then review.
The Probable causes:
The probable cause is fungal or bacterial or growth.Investigations to be done:
Do GTT (glucose tolerance test) and KOH test.Differential diagnosis:
The differential diagnosius is acute infection secondary to trauma and Beau's line due to internal disease.Probable diagnosis:
The probable diagnosis is onychomycosis.Treatment plan:
Take antifungal for one week per month for a minimum of three months.Preventive measures:
Avoid wet work. Keep hand dry.