OK, this is the information that you have supplied, thus far;
Could you please tell me what white lines running parallel to the nail bed signify? Surely it can't be Calcium deposits? The nail has the appearance of a 'zebra'!
All suggestions gratefully accepted!
There has been trauma in 2003. The nail was black and the damamged part removed. The nails have had these white striations since 2004. She has tried Terbinafine in 2005 for 5 weeks, Loceryl from 2006 for two years. There has been no change since then.
We`d like to be able to help, but I`m afraid you haven`t supplied enough relevant information to even begin. To hazard a guess at your patients condition, without first looking at the global picture (i.e. age and occupation of pt, overall physical health, systemic conditions, previous treatments, etc) and local manifestation, is foolhardy.
You state that there was trauma in 2003. Can you please elaborate on what this trauma consisted of? Which part of the nail was discoloured? You state part of it was removed, who did this and how? How many and specifically which
nails are manifesting symptoms? Are they painful? Are there any other lesions or conditions in the surrounding tissue? Was the terbinafine topical or oral? Why did she use this, i.e. were nail clippings and subungual tissue taken for microscopy and culture?
Without trying to state the bleedin` obvious; The most important aspect of diagnosing any dermatological condition, is observation. If you can`t obtain a photo, then a more detailed description will assist us in trying to help you.