9 years Old female History of long term cortisone therapy Please For Diagnosis and ttt Thanks

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Nail fungus. A number of different types of fungus can cause onychomycosis including dermatophytes and Fusarium. Risk factors include athlete's foot, other nail diseases, exposure to someone with the condition, peripheral vascular disease, and poor immune function. DD..Cushing syndrome

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Long term use of steroid cause suceptlble for Fungal infection, skin lesions, myopathy, growth retardation

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It's onychomycosis Treat accordingly Also Document vitals height weight BP Investigate CBC GLUCOSE PANEL, LIPIDS look for symptoms of adrenal crises and cushingoid features. Titre / taper steroid if possible

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DD: Nail psoriasis/ nail dystrophy Rx . Tab terbinafin 20 BD Tab. Cetrizine 5mg OD Tab. Itraconazole 100mg OD for 10days Tab. Fluconazole 150mg 2tab one tab weekly Clotrimazole in day Salicylic aicid in night Tab.

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Long term steroids produce immune suppression and susceptibility to fungal infection, here you see onychomycosis. And pigmentation of hands due to MSH Produced due to longterm steroid use .

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D/D.. * ONYCHOLYSIS.. * ONYCHOMYCOSIS.. * NAIL PSORIASIS..

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Onychomycosis Nail disease Melanoma Tinea unguium Ostomycosis Caps

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Onychomycosis

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Onychomycosis

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SUGGESTIVE OF STEROIDAL INDUCED FUNGAL INFECTION

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