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Hi Guys,
I have a client who has 3 black toenails, 2nd, 3rd and 5th on one foot. They have been black for 2 years.
No trauma, no bruising, swelling etc etc.. Previous pod was treating with daktarin, but Im not sure of the point, there is slight fungal infection, but client thinks its to stop the black, not the fungal infection.. so I see the point in using it for the infection, but not the black..
She has renal failure and Diabetes and heart problems.. Im wondering if it has something to do with the renal failure, thought I heard that once, but unsure and I cant find anything on the web..
She just wants to know why its happened.. and so do I!

Sorry for the slight rambling, friday afternoon is affecting me!

Any thoughts would be gratefully appreciated!

Lucy

 

Sorry Lucy, this is not 'answering slight rambling' Friday afternoon, please submit next one, all the best, mark

 

Fungal melanonychia ??

 

Could well be. Then again it may be increased melanocyte stimulation in the nail bed associated with kidney failure. Difficult to say without a pic.

 

Bel

if that was so why would it be limited to 3 nails?

 

Bob,

If they are acquired malanocytic naevi they wouldn't present in a bilateral or symmetrical pattern. It was only a suggestion and we can't really speculate any further without pics or more detail on whether the discoloration is in the nail bed or plate, if the whole nail is black or parts of it, etc.

That said, Terrys nails; half white half Brown can be seen in pts with renal failure and discoloured nails can be associated with diabetes and/or vascular problems.

I would recommend referral for biopsy to rule out any malignancy.

 

This paper may be useful.

Dave Smith

 

Hi Lucycool,
There is a fungal organism called Tricophyton Tonsurans that produces a black discoloration of the nails. Hopefully it would respond to one of the topical antifungals eg Loceryl paint.

Billquiet.

 

Can you upload pictures on here? Would be best to see it really. Could well be Fungal melanonychia.

 

Yep. That`s what i suggested....

BTW, :welcome: to the Arena, Merryn1

Cheers,
Bel