Bob presents with thickened toenails of 6 months duration on a background of working in construction. 

What is the cause of this presentation as seen in the picture?

1. Onychogryphosis

What are the causes of thickening of the nail plate?

1. Onychomycosis
2. Developmental
3. Trauma
4. Psoriasis
5. Onychogryphosis
6. Age related changes

Reading

1. Murtaghs General Practice Chapter 129 – http://murtagh.mhmedical.com/content.aspx?bookid=1522&sectionid=116046129
2. Murtaghs Practice Tips – Chapter 8 – Nail Problems – http://murtagh.mhmedical.com/content.aspx?bookid=1920&sectionid=143276631

Podcast

1. GP Core Content Podcast Episode 150 – Dermatology | Nails