What could cause deformity in finger nail with crack and discoloration?

Q. I have deep crack in only one nail with yellow discoloration. Please help.

Answered by
Dr. Subhash Kashyap
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Apr 22, 2020 and last reviewed on: Aug 11, 2023

Hi doctor,

I have a deformation on one of my fingernails with a deep crack and it is a bit yellow on a small part near the skin at the start of the nail. Please help.

#

Hi,

Welcome to icliniq.com.

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.

Thank you doctor,

I noticed it around a month ago. No trauma or I did not notice it. No history of high blood sugar or other disease and it is not painful.

#

Hi,

Welcome back to icliniq.com.

That's good. It is a fungal infection of the nail bed only. Follow the treatment given and it will slowly grow out.


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