This weeks medical challenge from the New England Journal of Medicine is a hard one. Patients come all the time with nail problems and most are easy to diagnose. Full disclosure to my readers...I missed this one. A couple of hints...all of the nails are obviously affected. Click on the image to enlarge and make your diagnosis in the comments section. I will post the answer tomorrow so be sure to check back and see how you did.
1. Melanoma
2. Onychomycosis (fungus)
3. Psoriasis
4. Yellow-nail syndrome
5. Zinc deficiency
Good luck!
1. Melanoma
2. Onychomycosis (fungus)
3. Psoriasis
4. Yellow-nail syndrome
5. Zinc deficiency
Good luck!

10 comments:
I'm going with yellow nail syndrome. (And pray I never contract it!)
I think it is yellow-nail syndrome.
I guess #1-melanoma
Yellow-nail syndrome seems too obvious. I wouldn't think that melanoma would affect all fingers. I'm going with Onychomycosis (fungus).
Looks like yellow nail syndrome to me. Isn't it some kind of issue with the lymphatics? Can't remember. Just remember that it looks like that.
Looks like No.2 to me.
LeRoi Johnson thinks it is fungus.
I guess yellow nail syndrome
This is tricky because the fact that it's a NEJM image challenge makes you want to choose something more obscure..
Without a history, I choose 2. Onychomycosis.
Otherwise, I'd expect it to be yellow nail syndrome. It's easier to rule out the others based on appearance and the fact that all digits are involved.
Jim
Symptoms show that it really is a yellow-nail syndrome and I think it is real one too.
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