Hi all, I have a patient who has presented today with a slightly tricky problem.
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He is a male, aged 55 and has chronic OM in all toenails and fingernails (this has been confirmed by lab test), and his nails are yellow, white, green and black, and thick on all areas. This has been present for 2 years. Previous treatment given at other clinics was the removal of all his nails, topical antifungals which have contained turbinafine, and another with itraconazole. Also natural antifungals which have contained oils such as lavender, teatree ect.
After using these every day for months at a time there has been no improvement, and according to the patient and his wife they have been very compliant with treatment.
The reason why this one is tricky is that at the same time this happened to all his nails, he also developed a "nose cold" which has been present for 2 years also, with a green yellow discharge on a daily basis. He has been to ENT clinics, had antibiotics, his sinus drained ect ect.. but no improvement. He also has had a few verrucae appear around the similar time, which he has never had before, and also said that he has tinea pedis 80% of the time. He also said that he seems to get sick very easily also.
He has had general bloods done, nothing has shown up. I am assuming there must be some sort of immune issue. Any thoughts?
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