The nail may be dystrophic and thick or it may have colored lines running through it.
Another presentation is with a white layer on the surface of the nail.
Sometimes the problem is in the nail bed causing the nail to lift ( Onycholysis) but this picture is more often seen in nail bed psoriasis.
Fungal infections may also start at the nail lateral edge.
There are new topical antifungal nail preparations coming available which actually penetrate the nail and can give cure rates of 60-80%. Otherwise Terbinafine should be used orally 250 mgs daily for 12 weeks.
