Changing colors.

78 y, AAW, h/o nonspecific interstitial pneumonitis, undifferentiated connective tissue disease (ANA-1:640 speckled pattern, +Anti-Ro Ab), comes to the office with intermittent bluish discoloration of her fingers.

What is the diagnosis?

Raynaud's disease.

Yellow nails

50 yr woman, employed at the Shopper’s deli, presents with fingernails discoloration for the past few months. She has a PMH of HTN, being treated with HCTZ and Enalapril.
Exam shows yellowish- brown, brittle and broken fingernails involving both hands.

Which of the following statements is true?

1. This is most likely a dermatophyte infection due to Trichophyton Rubrum
2. It is classified as superficial onychomycosis.
3. Most insurance companies do not require histopathological diagnosis for reimbursement of the treatment.
4. Itraconazole is superior to Terbinafine for this type of onychomycosis- Answer
5. This is a classic presentation of psoriatic nails.