This 16-year-old girl presented wwith a 2 month history of discoloration and thickening of the finger nails and toe nails. She failed to improve with oral antifungal therapy, and fungal cultures were subsequently negative. She had a history of recurrent upper and lower respiratory tract infections, chronic nonproductive cough and intermittent dyspnea. She was treated for recurrent left serous ofitis media because of a dull yellow tympanic membrane. Further evaluation included a chest x-ray and computed tomography which demonstrated laft basilar scarring with pleural thickening. Pulmonary function tests showed mild obstructive lung disease.
Description
diffuse dark yellowing of the nails with increased transverse curvature
