A seventy-eight year-old man presents with onycholysis which affects both
Hallux and second and third toenails. No evidence of trauma or
onychomycosis and the nail bed appears similar in nature to a successful
phenol matrixectomy i.e. pink healthy skin! There is no evidence of new
nail growth. The left Hallux nail avulsed first – six months ago – followed
by the right Hallux one month later. The lesser toenails avulsed within the
last two months. Any ideas?
**************************************
Active Medical Problems
Ventricular cardiac aneurysm (Rx aneurysmectomy – gelseal patch 1998)
Angina
Chronic obstructive pulmonary disease
Congestive cardiac failure
Ischaemic heart disease
Pagets Disease (mild in pelvis)
Peripheral neuropathy
Polyneuropathy (recent nerve conduction studies reveal moderate axonal
motor sensory polyneuropathy – worse in lower limbs)
Paraesthesia (both hands)
Present Medication
Ipratropium Bromide Inhaler
Tamsulosin Hydrochloride 400mcgms
Co-codamol
Gaviscon
Enalapril Maleate 10mgs
Quinine Bisulphate 300mgs
Manevac Granules 400gms
Fluvastatin Capsules 40mgs
Terbutaline Inhaler
Etoricoxib Tablets 90mgs
Furosemide Tablets 20mgs
*************************************************
Thanks in anticipation…..
Mark Russell
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