What is the diagnosis and treatment

please guide me in this case 50yr old Female housemaker who is non DM/HTN , known case of Rheumatoid arthritis ( 9yrs) , Bronchial asthma ( more than 10 yrs- not using inhaler) C/O nail bed pain and itching finger nails and toe nails for 10yrs . First noted as skin drying and later nail bed pain on 2010 . One yr later nails get brittiled. Taken allopathic treatment on 2012 and they recently advised for surgery. Condition aggravates while washing utensils, clothes. Gets relieved by application of moisturiser or any oil .Now the itching and dryness aggravated during lockdown days and she use to apply turmeric and neem paste in nails. No dandruff noted in scalp. Along with this complaint of nail bed itching &pain ... She complaints of pricking type of pain in right chest and difficulty in breathing during night time. Symptoms used to get subsided by taking steam inhalation. Sometimes she also c/o pricking type of pain in right chest region radiates to right hand. Sir ,I'm attaching pictures. Diagnosis ?



Chronic parnochya. Needs proper antiseptic dressing and antifungal cream apply locally. Sy. Septilin 10ml BDPC X 3 month. Sy. Liv52 10ml BDAC X 3 month. Intake fresh fruit and vegetables.

Seems to be a case of chronic paronychia by fungal ( candida ) infection due to too much contact with water or soap water. There may be an added bacterial infection with the complaint.Blackish discoloration may be either due to fungal infection or from blockge of peripheral circulation ( gangrene ? ). Please check the reason for surgery

Difficult to consider her back history but at this stage think about "Galit Kushth " sympotems.@Dr. Roshni S .ji.

Shelcal Calcitriol Tab Evion Massage nails with Flaxseed oil or Jojoba oil Mother tincture Aspidosperma 10 drops qds. NSAIDs for Rheumatoid Arthritis




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