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Today I have a male client age 35 who presented with white shiny nails that looked as though they had a coat of translucent nail varnish on them. All the nails fingers and toes were the same, no dystrophy, no flakeyness, no lines. You can see the nail beds blanch when pressed and return a slight pinkness thru the nail. The skin is healthy with no lesions. Below are pictures. Any ideas what this might be? I dont think it is Superficial white onychomycosis and my best guess would be psoriasis although there are no skin lesions or signs anywhere else and it really does not resemble psoriatic nail presentation.
Onset was sudden and 5 years ago while working as a dive leader in Bahamas. He remember using a lot of bleach and heavy duty cleaners on decking etc. He denies any contact with heavy metals and the only medication he takes is ventolin for Asthma. There do not appear to be any other medical problems or signs of systemic disease. He is 175cm tall and weighs 100kg and presently works in the Phillipines as a Dive instructor.
Cheers Dave
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